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Ectopic Neuroblastoma in Monozygotic Twins With Different Ages of Onset: Possible Twin-to-Twin Metastasis In Utero With Distinct Genetic Alterations After Birth

Taketani, Takeshi MD; Takita, Junko MD; Ueyama, Junichi MD; Kanai, Rie MD; Kumori, Koji MD; Maruyama, Riruke MD; Hayashi, Kazuhiko MD; Ogawa, Seishi MD; Fukuda, Seiji MD; Yamaguchi, Seiji MD

Journal of Pediatric Hematology/Oncology: March 2014 - Volume 36 - Issue 2 - p 166–168
doi: 10.1097/MPH.0b013e318290c686
Clinical and Laboratory Observations

We describe neuroblastoma (NB) in monozygotic twins whose ages at the onset of the disease had a 3-year interval. The primary tumor site of twin 1 was the adrenal gland, whereas that of twin 2 was the jejunum/mesentery. MYCN amplification, DNA index, ALK mutation, and copy number alterations of DNA were different between each primary tumor. NB in ectopic sites may have resulted from twin-to-twin metastasis through vascular anastamoses in the placenta. The pathogenesis of this NB involved a premalignant stage of NB during the fetal development and subsequent molecular alterations after birth, resulting in NBs that were phenotypically similar but genetically different.

*Division of Blood Transfusion, Shimane University Hospital

Department of Pediatrics

Department of Digestive and General Surgery, Shimane University School of Medicine

Department of Organ Pathology, Shimane University Faculty of Medicine, Shimane

Department of Cell Therapy and Transplantation Medicine, Pediatrics Cancer Genomics Project

**Cancer Genomics Project, Graduate School of Medicine, University of Tokyo, Tokyo

§Division of Pediatrics and Perinatology, Tottori University School of Medicine

#Division of Molecular Pathology, Tottori University Faculty of Medicine, Tottori, Japan

The authors declare no conflict of interest.

Reprints: Takeshi Taketani, MD, PhD, Division of Blood Transfusion, Shimane University Hospital, 89-1 Enya, Izumo, Shimane 963-8501, Japan (e-mail:

Received December 5, 2012

Accepted March 3, 2013

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