Skip to main content
Journal of Medical Genetics logoLink to Journal of Medical Genetics
. 1999 May;36(5):360–364.

Phenotypic findings of Cowden syndrome and Bannayan-Zonana syndrome in a family associated with a single germline mutation in PTEN

J T Celebi 1, H Tsou 1, F F Chen 1, H Zhang 1, X L Ping 1, M Lebwohl 1, J Kezis 1, M Peacocke 1
PMCID: PMC1734369  PMID: 10353779

Abstract

Cowden syndrome (CS) and Bannayan-Zonana syndrome (BZS) are two hamartoma syndromes with distinct phenotypic features. Although partial clinical overlap exists between CS and BZS, they are considered to be separate entities. PTEN has been identified as the susceptibility gene for both disorders, suggesting allelism. We have identified a germline mutation, R335X, in PTEN in a family consisting of two female members with the phenotypic findings of CS and two male members with the phenotypic findings of BZS. To our knowledge, this is the first report that shows the presence of separate subjects with CS and with BZS in a single family associated with a single germline PTEN mutation.


Keywords: Cowden syndrome; Bannayan-Zonana syndrome; PTEN

Full Text

The Full Text of this article is available as a PDF (122.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Albrecht S., Haber R. M., Goodman J. C., Duvic M. Cowden syndrome and Lhermitte-Duclos disease. Cancer. 1992 Aug 15;70(4):869–876. doi: 10.1002/1097-0142(19920815)70:4<869::aid-cncr2820700424>3.0.co;2-e. [DOI] [PubMed] [Google Scholar]
  2. Bannayan G. A. Lipomatosis, angiomatosis, and macrencephalia. A previously undescribed congenital syndrome. Arch Pathol. 1971 Jul;92(1):1–5. [PubMed] [Google Scholar]
  3. Brownstein M. H., Mehregan A. H., Bilowski J. B. Trichilemmomas in Cowden's disease. JAMA. 1977 Jul 4;238(1):26–26. [PubMed] [Google Scholar]
  4. Brownstein M. H., Wolf M., Bikowski J. B. Cowden's disease: a cutaneous marker of breast cancer. Cancer. 1978 Jun;41(6):2393–2398. doi: 10.1002/1097-0142(197806)41:6<2393::aid-cncr2820410644>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  5. Cohen M. M., Jr Bannayan-Riley-Ruvalcaba syndrome: renaming three formerly recognized syndromes as one etiologic entity. Am J Med Genet. 1990 Feb;35(2):291–292. doi: 10.1002/ajmg.1320350231. [DOI] [PubMed] [Google Scholar]
  6. DiLiberti J. H., Weleber R. G., Budden S. Ruvalcaba-Myhre-Smith syndrome: a case with probable autosomal-dominant inheritance and additional manifestations. Am J Med Genet. 1983 Jul;15(3):491–495. doi: 10.1002/ajmg.1320150315. [DOI] [PubMed] [Google Scholar]
  7. Eng C., Murday V., Seal S., Mohammed S., Hodgson S. V., Chaudary M. A., Fentiman I. S., Ponder B. A., Eeles R. A. Cowden syndrome and Lhermitte-Duclos disease in a family: a single genetic syndrome with pleiotropy? J Med Genet. 1994 Jun;31(6):458–461. doi: 10.1136/jmg.31.6.458. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Fargnoli M. C., Orlow S. J., Semel-Concepcion J., Bolognia J. L. Clinicopathologic findings in the Bannayan-Riley-Ruvalcaba syndrome. Arch Dermatol. 1996 Oct;132(10):1214–1218. [PubMed] [Google Scholar]
  9. Gorlin R. J., Cohen M. M., Jr, Condon L. M., Burke B. A. Bannayan-Riley-Ruvalcaba syndrome. Am J Med Genet. 1992 Oct 1;44(3):307–314. doi: 10.1002/ajmg.1320440309. [DOI] [PubMed] [Google Scholar]
  10. Halal F. Male to male transmission of cerebral gigantism. Am J Med Genet. 1982 Aug;12(4):411–419. doi: 10.1002/ajmg.1320120405. [DOI] [PubMed] [Google Scholar]
  11. Higginbottom M. C., Schultz P. The Bannayan syndrome: an autosomal dominant disorder consisting of macrocephaly, lipomas, hemangiomas, and risk for intracranial tumors. Pediatrics. 1982 May;69(5):632–634. [PubMed] [Google Scholar]
  12. LLOYD K. M., 2nd, DENNIS M. Cowden's disease. A possible new symptom complex with multiple system involvement. Ann Intern Med. 1963 Jan;58:136–142. doi: 10.7326/0003-4819-58-1-136. [DOI] [PubMed] [Google Scholar]
  13. Li D. M., Sun H. TEP1, encoded by a candidate tumor suppressor locus, is a novel protein tyrosine phosphatase regulated by transforming growth factor beta. Cancer Res. 1997 Jun 1;57(11):2124–2129. [PubMed] [Google Scholar]
  14. Li J., Yen C., Liaw D., Podsypanina K., Bose S., Wang S. I., Puc J., Miliaresis C., Rodgers L., McCombie R. PTEN, a putative protein tyrosine phosphatase gene mutated in human brain, breast, and prostate cancer. Science. 1997 Mar 28;275(5308):1943–1947. doi: 10.1126/science.275.5308.1943. [DOI] [PubMed] [Google Scholar]
  15. Liaw D., Marsh D. J., Li J., Dahia P. L., Wang S. I., Zheng Z., Bose S., Call K. M., Tsou H. C., Peacocke M. Germline mutations of the PTEN gene in Cowden disease, an inherited breast and thyroid cancer syndrome. Nat Genet. 1997 May;16(1):64–67. doi: 10.1038/ng0597-64. [DOI] [PubMed] [Google Scholar]
  16. Longy M., Coulon V., Duboué B., David A., Larrègue M., Eng C., Amati P., Kraimps J. L., Bottani A., Lacombe D. Mutations of PTEN in patients with Bannayan-Riley-Ruvalcaba phenotype. J Med Genet. 1998 Nov;35(11):886–889. doi: 10.1136/jmg.35.11.886. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lynch E. D., Ostermeyer E. A., Lee M. K., Arena J. F., Ji H., Dann J., Swisshelm K., Suchard D., MacLeod P. M., Kvinnsland S. Inherited mutations in PTEN that are associated with breast cancer, cowden disease, and juvenile polyposis. Am J Hum Genet. 1997 Dec;61(6):1254–1260. doi: 10.1086/301639. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Marsh D. J., Coulon V., Lunetta K. L., Rocca-Serra P., Dahia P. L., Zheng Z., Liaw D., Caron S., Duboué B., Lin A. Y. Mutation spectrum and genotype-phenotype analyses in Cowden disease and Bannayan-Zonana syndrome, two hamartoma syndromes with germline PTEN mutation. Hum Mol Genet. 1998 Mar;7(3):507–515. doi: 10.1093/hmg/7.3.507. [DOI] [PubMed] [Google Scholar]
  19. Marsh D. J., Dahia P. L., Zheng Z., Liaw D., Parsons R., Gorlin R. J., Eng C. Germline mutations in PTEN are present in Bannayan-Zonana syndrome. Nat Genet. 1997 Aug;16(4):333–334. doi: 10.1038/ng0897-333. [DOI] [PubMed] [Google Scholar]
  20. Miles J. H., Zonana J., Mcfarlane J., Aleck K. A., Bawle E. Macrocephaly with hamartomas: Bannayan-Zonana syndrome. Am J Med Genet. 1984 Oct;19(2):225–234. doi: 10.1002/ajmg.1320190204. [DOI] [PubMed] [Google Scholar]
  21. Nelen M. R., Padberg G. W., Peeters E. A., Lin A. Y., van den Helm B., Frants R. R., Coulon V., Goldstein A. M., van Reen M. M., Easton D. F. Localization of the gene for Cowden disease to chromosome 10q22-23. Nat Genet. 1996 May;13(1):114–116. doi: 10.1038/ng0596-114. [DOI] [PubMed] [Google Scholar]
  22. Nelen M. R., van Staveren W. C., Peeters E. A., Hassel M. B., Gorlin R. J., Hamm H., Lindboe C. F., Fryns J. P., Sijmons R. H., Woods D. G. Germline mutations in the PTEN/MMAC1 gene in patients with Cowden disease. Hum Mol Genet. 1997 Aug;6(8):1383–1387. doi: 10.1093/hmg/6.8.1383. [DOI] [PubMed] [Google Scholar]
  23. Ruvalcaba R. H., Myhre S., Smith D. W. Sotos syndrome with intestinal polyposis and pigmentary changes of the genitalia. Clin Genet. 1980 Dec;18(6):413–416. doi: 10.1111/j.1399-0004.1980.tb01785.x. [DOI] [PubMed] [Google Scholar]
  24. Salem O. S., Steck W. D. Cowden's disease (multiple hamartoma and neoplasia syndrome). A case report and review of the English literature. J Am Acad Dermatol. 1983 May;8(5):686–696. doi: 10.1016/s0190-9622(83)70081-2. [DOI] [PubMed] [Google Scholar]
  25. Schrager C. A., Schneider D., Gruener A. C., Tsou H. C., Peacocke M. Clinical and pathological features of breast disease in Cowden's syndrome: an underrecognized syndrome with an increased risk of breast cancer. Hum Pathol. 1998 Jan;29(1):47–53. doi: 10.1016/s0046-8177(98)90389-6. [DOI] [PubMed] [Google Scholar]
  26. Steck P. A., Pershouse M. A., Jasser S. A., Yung W. K., Lin H., Ligon A. H., Langford L. A., Baumgard M. L., Hattier T., Davis T. Identification of a candidate tumour suppressor gene, MMAC1, at chromosome 10q23.3 that is mutated in multiple advanced cancers. Nat Genet. 1997 Apr;15(4):356–362. doi: 10.1038/ng0497-356. [DOI] [PubMed] [Google Scholar]
  27. Tsou H. C., Ping X. L., Xie X. X., Gruener A. C., Zhang H., Nini R., Swisshelm K., Sybert V., Diamond T. M., Sutphen R. The genetic basis of Cowden's syndrome: three novel mutations in PTEN/MMAC1/TEP1. Hum Genet. 1998 Apr;102(4):467–473. doi: 10.1007/s004390050723. [DOI] [PubMed] [Google Scholar]
  28. Tsou H. C., Teng D. H., Ping X. L., Brancolini V., Davis T., Hu R., Xie X. X., Gruener A. C., Schrager C. A., Christiano A. M. The role of MMAC1 mutations in early-onset breast cancer: causative in association with Cowden syndrome and excluded in BRCA1-negative cases. Am J Hum Genet. 1997 Nov;61(5):1036–1043. doi: 10.1086/301607. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Weary P. E., Gorlin R. J., Gentry W. C., Jr, Comer J. E., Greer K. E. Multiple hamartoma syndrome (Cowden's disease). Arch Dermatol. 1972 Nov;106(5):682–690. [PubMed] [Google Scholar]
  30. Yen B. C., Kahn H., Schiller A. L., Klein M. J., Phelps R. G., Lebwohl M. G. Multiple hamartoma syndrome with osteosarcoma. Arch Pathol Lab Med. 1993 Dec;117(12):1252–1254. [PubMed] [Google Scholar]
  31. Zonana J., Rimoin D. L., Davis D. C. Macrocephaly with multiple lipomas and hemangiomas. J Pediatr. 1976 Oct;89(4):600–603. doi: 10.1016/s0022-3476(76)80397-6. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Medical Genetics are provided here courtesy of BMJ Publishing Group

RESOURCES