Consol López San Martin, Enrique Lastra, Mercedes Robledo, José María Mesa-Latorre, Gemma Llort, María Fonfria, Luis Gómez, Judith Balmaña, A Beatriz Sánchez-Heras, Adela Castillejo, Alexandre Teulé, Pere Berbel, Teresa Ramón y Cajal, Juan de Dios García-Díaz, Ángel Zúñiga, Mercedes Durán, Adrià López-Fernández, Isabel Chirivella, M. Isabel Castillejo, Luis Robles, Inés Escandell, Raquel Perea Ibañez, Carmen Yagüe, Rosario Sánchez, José Luis Soto, Universidad de Alicante. Departamento de Biotecnología, Universidad de Alicante. Departamento de Fisiología, Genética y Microbiología, Biotecnología, Genética Humana y de Mamíferos (GHM), Institut Català de la Salut, [Sánchez-Heras AB] Cancer Genetic Counselling Unit, Medical Oncology Department, Hospital General Universitario de Elche, Elche, Spain. [Castillejo A] Molecular Genetics Unit, Hospital General Universitario de Elche, Elche, Spain. [García-Díaz JD] Clinical Genetics Unit, Department of Internal Medicine, University Hospital Príncipe de Asturias, Alcalá de Henares, Spain. [Robledo M] Hereditary Endocrine Cancer Group, Spanish National Cancer Research Center (CNIO), Madrid, Spain. Centro de Investigación Biomédica en Red de Enfermedades Raras, CIBERER, Madrid, Spain. [Teulé A] Hereditary Cancer Program, Catalan Institute of Oncology, Instituto de Investigación Biomédica de Bellvitge, Hospitalet de Llobregat, Spain. [Sánchez R] Unidad Multidisciplinar de Enfermedades de Baja Prevalencia, Instituto de Investigación Sanitaria y Biomédica de Alicante (ISABIAL), Hospital General Universitario de Alicante, Alicante, Spain. [López-Fernández A, Balmaña J] Hereditary Cancer Genetics Group, Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain. Servei d’Oncologia Mèdica, Vall d’Hebron Hospital Universitari, Barcelona, Spain, and Vall d'Hebron Barcelona Hospital Campus
Simple Summary Hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome is a very rare hereditary disorder characterized by cutaneous leiomyomas (CLMs), uterine leiomyomas (ULMs), renal cysts (RCys) and renal cell cancer (RCC), with no data on its prevalence worldwide. No genotype-phenotype associations have been described. The aim of our study was to describe the genotypic and phenotypic features of the largest series of patients with HLRCC from Spain reported to date. Of 27 FH germline pathogenic variants, 12 were not previously reported in databases. Patients with missense pathogenic variants showed higher frequencies of CLMs, ULMs and RCys, than those with loss-of-function variants. The frequency of RCCs (10.9%) was lower than those reported in the previously published series. Hereditary leiomyomatosis and renal cell cancer syndrome (HLRCC) is a very rare hereditary disorder characterized by cutaneous leiomyomas (CLMs), uterine leiomyomas (ULMs), renal cysts (RCys) and renal cell cancers (RCCs). We aimed to describe the genetics, clinical features and potential genotype-phenotype associations in the largest cohort of fumarate hydratase enzyme mutation carriers known from Spain using a multicentre, retrospective study of individuals with a genetic or clinical diagnosis of HLRCC. We collected clinical information from medical records, analysed genetic variants and looked for genotype-phenotype associations. Analyses were performed using R 3.6.0. software. We included 197 individuals: 74 index cases and 123 relatives. CLMs were diagnosed in 65% of patients, ULMs in 90% of women, RCys in 37% and RCC in 10.9%. Twenty-seven different pathogenic variants were detected, 12 (44%) of them not reported previously. Patients with missense pathogenic variants showed higher frequencies of CLMs, ULMs and RCys, than those with loss-of-function variants (p = 0.0380, p = 0.0015 and p = 0.024, respectively). This is the first report of patients with HLRCC from Spain. The frequency of RCCs was lower than those reported in the previously published series. Individuals with missense pathogenic variants had higher frequencies of CLMs, ULMs and RCys.