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A Genotypic and Histopathological Study of a Large Dutch Kindred with Hyperparathyroidism-Jaw Tumor Syndrome¹

Department of Pathology (C.J.H., H.M.), Department of Endocrinology (E.W.C.M.v.D.), Department of Clinical Genetics (C.v.A.), Department of Anthropogenetics (C.R.), Leiden University Medical Center, 2300 RC Leiden, The Netherlands; Department of Molecular Medicine (F.K.W., C.L.), Karolinska Hospital, Stockholm, S-17176 Sweden; Department of Medical Genetics (R.v.d.L., M.d.W.), Department of Internal Medicine (J.J., C.J.L.), Department of Internal Medicine and Pathology (J.R., J.H.), University Medical Center Utrecht, 3500 AB Utrecht, The Netherlands; and VanAndel Research Institute (B.T.T.), Grand Rapids, Michigan 49503

Address correspondence and requests for reprints to: Dr. Hans Morreau, Department of Pathology, Leiden University Medical Center, P.O. Box 9600, L1-Q, Building I, 2300 RC Leiden, The Netherlands. E-mail: jmorreau{at}pat.azl.nl

Familial primary hyperparathyroidism is the main feature of 2 familial endocrine neoplasia syndromes: multiple endocrine neoplasia type 1 (MEN 1) and hyperparathyroidism-jaw tumor syndrome (HPT-JT). The latter is a recently described syndrome that has been associated with ossifying fibroma of the jaw and various types of renal lesions, including benign cysts, Wilms’ tumor, and hamartomas. To further illustrate the natural history of this syndrome, we describe a large, previously unreported Dutch kindred in which 13 affected members presented with either parathyroid adenoma or carcinoma; in 5 affected individuals, cystic kidney disease was found. Additionally, pancreatic adenocarcinoma, renal cortical adenoma, papillary renal cell carcinoma, testicular mixed germcell tumor with major seminoma component, and Hürthle cell thyroid adenoma were also identified. Linkage analysis of the family using MEN1-linked microsatellite markers and mutation analysis excluded the involvement of the MEN1 gene. Using markers from the HPT-JT region in 1q25–31, cosegregation with the disease was found, with a maximum logarithm of odds score of 2.41 obtained for 6 markers using the most conservative calculation. Meiotic telomeric recombination between D1S413 and D1S477 was identified in 3 affected individuals, and when combined with previous reports, delineated the HPT-JT region to 14 centimorgan. Combined comparative genomic hybridization and loss of heterozygosity data revealed complex genetic abnormalities in the tumors, suggesting different possible genetic mechanisms for the disease.

In conclusion, we report a family with hyperparathyroidism linked to chromosome 1q, and exhibiting several types of renal and endocrine tumors that have not been previously described.

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