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Review
. 2018 May 15;24(10):2251-2261.
doi: 10.1158/1078-0432.CCR-17-3089. Epub 2018 Jan 17.

DICER1 and Associated Conditions: Identification of At-risk Individuals and Recommended Surveillance Strategies

Kris Ann P Schultz  1   2   3 , Gretchen M Williams  4   2   3 , Junne Kamihara  5 , Douglas R Stewart  6 , Anne K Harris  4   2   3 , Andrew J Bauer  7 , Joyce Turner  8 , Rachana Shah  9 , Katherine Schneider  10 , Kami Wolfe Schneider  11 , Ann Garrity Carr  12 , Laura A Harney  12 , Shari Baldinger  13 , A Lindsay Frazier  5 , Daniel Orbach  14 , Dominik T Schneider  15 , David Malkin  16 , Louis P Dehner  17 , Yoav H Messinger  4   2   3 , D Ashley Hill  18
Affiliations
Review

DICER1 and Associated Conditions: Identification of At-risk Individuals and Recommended Surveillance Strategies

Kris Ann P Schultz et al. Clin Cancer Res. .

Abstract

Pathogenic germline DICER1 variants cause a hereditary cancer predisposition syndrome with a variety of manifestations. In addition to conferring increased cancer risks for pleuropulmonary blastoma (PPB) and ovarian sex cord-stromal tumors, particularly Sertoli-Leydig cell tumor, individuals with pathogenic germline DICER1 variants may also develop lung cysts, cystic nephroma, renal sarcoma and Wilms tumor, nodular hyperplasia of the thyroid, nasal chondromesenchymal hamartoma, ciliary body medulloepithelioma, genitourinary embryonal rhabdomyosarcoma, and brain tumors including pineoblastoma and pituitary blastoma. In May 2016, the International PPB Registry convened the inaugural International DICER1 Symposium to develop consensus testing and surveillance and treatment recommendations. Attendees from North America, Europe, and Russia provided expert representation from the disciplines of pediatric oncology, endocrinology, genetics, genetic counseling, radiology, pediatric surgery, pathology, and clinical research. Recommendations are provided for genetic testing; prenatal management; and surveillance for DICER1-associated pulmonary, renal, gynecologic, thyroid, ophthalmologic, otolaryngologic, and central nervous system tumors and gastrointestinal polyps. Risk for most DICER1-associated neoplasms is highest in early childhood and decreases in adulthood. Individual and caregiver education and judicious imaging-based surveillance are the primary recommended approaches. These testing and surveillance recommendations reflect a consensus of expert opinion and current literature. As DICER1 research expands, guidelines for screening and treatment will continue to be updated. Clin Cancer Res; 24(10); 2251-61. ©2018 AACR.

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Conflict of interest statement

Conflict of Interest Disclosure Statement: The authors have no conflicts of interest to disclose.

Figures

Figure 1.
Figure 1.
QUORUM diagram for screening evidence review.
Figure 2.
Figure 2.
Age and incidence of cystic nephroma (blue) and Wilms tumor (red) in individuals known to the International PPB Registry.
See this image and copyright information in PMC

Comment in

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