Li Fraumeni syndrome (LFS) was
described in 1969, initially organized through clinical observations followed
by epidemiological studies. Corresponds to a rare syndrome, autosomal dominant
negative characterized by inherited mutations that occur in the germline,
especially p53 (approximately 70% of cases) and a clinical phenotype of
multiple primary neoplasms. Thus, it is characterized by a predisposition to
cancer, and those with 50 years have a probability of twenty-five times more
likely to develop various types of malignant tumors, compared with the general
population. The LFS is related to a high mortality rate as a result of
different locations of neoplasms and systemic consequences arising.
Molecular diagnosis and genetic
counseling Tracking Since LFS is rare that no epidemiological achieves a
well-defined population and shows no clinical manifestations predictable, nor a
specific treatment, methods of screening are not yet routine in human genetics.
Early detection of germline mutation of TP53 in tumor patients can be offered
for both children as well as adults, in a context of psychosocial support to
confirm the molecular basis for LFS. This will at least offer the patient an
ongoing clinical review and sometimes future diagnosing cancers at an early
stage. However, genetic counseling is still one of the major difficulties in
the LFS. After all, phenotypic diversity is extensive, ranging from mild
clinical implications neoplasms sarcomas in children and even brain tumors,
making planning for the future and assessing prognosis. Furthermore, inheriting
a mutation of TP53 is no guarantee that the cancer develops, as this will arise
by the accumulation of somatic mutations during life. Thus, much more must be
known about the pathogenesis of the disease so that you can make a effective
counseling for families with molecular predisposition to cancer. Despite
treatment advances in molecular methods to detect mutation has not yet
developed an effective method of treatment of this syndrome. However, early
detection of the mutation may provide important information and guidance for
future interventions. Before starting a specific treatment, all patients should
have their diagnosis of cancer confirmed by histopathology tissue. Currently,
there are the following alternatives for the treatment of cancer: surgery,
radiation, chemotherapy, hormone therapy, immunotherapy and biotherapy. The
decision of the best treatment depends on the location, type, extent, and
number of tumors, and especially the patient's clinical condition. The main
goal of therapy is still providing relief of symptoms, with a better quality of
life. The germline gene therapy in humans has not been used by ethical concepts
and the limitations of technology for manipulation of germline cells.
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