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Clonal cytogenetic evolution in a squamous cell carcinoma of the skin from a xeroderma pigmentosum patient.
[monosomy 21]
Cytogenetic
changes
in
epithelial
neoplasms
are
often
complex
,
making
it
difficult
to
determine
which
are
the
primary
abnormalities
and
which
are
secondary
.
In
this
report
,
we
describe
clonal
evolution
in
a
cytogenetically
simple
,
but
clinically
aggressive
squamous
cell
cancer
of
the
skin
from
a
patient
with
xeroderma
pigmentosum
.
Chromosome
preparations
were
analyzed
from
a
direct
harvest
,
three
independent
primary
harvests
,
and
passaged
cell
lines
.
Three
closely
related
tumor
subclones
were
identified
in
the
primary
cultures
,
and
all
three
proliferated
in
vitro
.
Monosomy
4
and
a
chromosome
9
rearrangement
were
present
in
all
three
subclones
and
monosomy
21
was
present
in
two
subclones
.
An
i
(
9
p
)
and
an
i
(
9
q
)
were
derived
from
the
same
chromosome
9
,
and
there
was
concurrent
loss
of
the
homologous
chromosome
9
.
In
addition
,
each
subclone
was
characterized
by
a
further
specific
evolutionary
change
:
t
(
5
;
7
)
(
q
11
.
2
;
p
22
)
in
subclone
1
,
der
(
11
)
t
(
10
;
11
)
(
q
21
;
p
14
)
in
subclone
2
,
and
der
(
14
)
t
(
13
;
14
)
(
q
14
;
q
32
)
in
subclone
3
.
All
three
subclones
were
represented
by
hypodiploid
and
hypotetraploid
metaphases
.
Loss
of
chromosomes
from
hypotetraploid
cells
and
an
11
q
+
were
the
only
other
changes
found
in
this
tumor
.
The
early
genetic
events
in
the
evolution
of
this
squamous
cell
cancer
,
monosomy
4
,
i
(
9
p
)
,
i
(
9
q
)
,
and
monosomy
21
,
represent
loss
of
chromosome
regions
that
are
commonly
lost
in
other
squamous
cell
carcinomas
of
the
head
and
neck
region
.
Taken
together
,
these
observations
indicate
that
genes
on
these
chromosomal
regions
are
probably
important
and
possibly
sufficient
for
the
development
of
squamous
cell
carcinoma
.
Diseases
Validation
Diseases presenting
"early genetic events in the evolution of this squamous cell cancer"
symptom
monosomy 21
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