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Association of germline variants in telomere maintenance genes (POT1, TERF2IP, ACD, and TERT) with spitzoid morphology in familial melanoma: A multi-center case series.


ABSTRACT:

Background

Spitzoid morphology in familial melanoma has been associated with germline variants in POT1, a telomere maintenance gene (TMG), suggesting a link between telomere biology and spitzoid differentiation.

Objective

To assess if familial melanoma cases associated with germline variants in TMG (POT1, ACD, TERF2IP, and TERT) commonly exhibit spitzoid morphology.

Methods

In this case series, melanomas were classified as having spitzoid morphology if at least 3 of 4 dermatopathologists reported this finding in ≥25% of tumor cells. Logistic regression was used to calculate odds ratios (OR) of spitzoid morphology compared to familial melanomas from unmatched noncarriers that were previously reviewed by a National Cancer Institute dermatopathologist.

Results

Spitzoid morphology was observed in 77% (23 of 30), 75% (3 of 4), 50% (2 of 4), and 50% (1 of 2) of melanomas from individuals with germline variants in POT1, TERF2IP, ACD, and TERT, respectively. Compared to noncarriers (n = 139 melanomas), POT1 carriers (OR = 225.1, 95% confidence interval: 51.7-980.5; P < .001) and individuals with TERF2IP, ACD, and TERT variants (OR = 82.4, 95% confidence interval: 21.3-494.6; P < .001) had increased odds of spitzoid morphology.

Limitations

Findings may not be generalizable to nonfamilial melanoma cases.

Conclusion

Spitzoid morphology in familial melanoma could suggest germline alteration of TMG.

SUBMITTER: Goldstein AM 

PROVIDER: S-EPMC9978843 | biostudies-literature | 2023 Jun

REPOSITORIES: biostudies-literature

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Publications

Association of germline variants in telomere maintenance genes (&lt;i&gt;POT1, TERF2IP, ACD,&lt;/i&gt; and &lt;i&gt;TERT&lt;/i&gt;) with spitzoid morphology in familial melanoma: A multi-center case series.

Goldstein Alisa M AM   Qin Richard R   Chu Emily Y EY   Elder David E DE   Massi Daniela D   Adams David J DJ   Harms Paul W PW   Robles-Espinoza Carla Daniela CD   Newton-Bishop Julia A JA   Bishop D Timothy DT   Harland Mark M   Holland Elizabeth A EA   Cust Anne E AE   Schmid Helen H   Mann Graham J GJ   Puig Susana S   Potrony Miriam M   Alos Llucia L   Nagore Eduardo E   Millán-Esteban David D   Hayward Nicholas K NK   Broit Natasa N   Palmer Jane M JM   Nathan Vaishnavi V   Berry Elizabeth G EG   Astiazaran-Symonds Esteban E   Yang Xiaohong R XR   Tucker Margaret A MA   Landi Maria Teresa MT   Pfeiffer Ruth M RM   Sargen Michael R MR  

JAAD international 20230130


<h4>Background</h4>Spitzoid morphology in familial melanoma has been associated with germline variants in <i>POT1</i>, a telomere maintenance gene (TMG), suggesting a link between telomere biology and spitzoid differentiation.<h4>Objective</h4>To assess if familial melanoma cases associated with germline variants in TMG (<i>POT1</i>, <i>ACD</i>, <i>TERF2IP</i>, and <i>TERT</i>) commonly exhibit spitzoid morphology.<h4>Methods</h4>In this case series, melanomas were classified as having spitzoid  ...[more]

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