Inherited pulmonary cylindromas: extending the phenotype of CYLD mutation carriers

Br J Dermatol. 2018 Sep;179(3):662-668. doi: 10.1111/bjd.16573. Epub 2018 May 29.

Abstract

Background: Germline mutations in the tumour suppressor gene CYLD are recognized to be associated with the development of multiple cutaneous cylindromas. We encountered such a patient who presented with breathlessness because of multiple pulmonary cylindromas.

Objectives: To search for clinical and radiological features of multiple pulmonary cylindromas in a cohort of 16 patients with CYLD mutations.

Methods: A retrospective case-note review was carried out in a tertiary dermatogenetics clinic where CYLD mutation carriers are reviewed on an annual basis. In-depth investigation was carried out for patients with pulmonary tumours.

Results: Four patients had radiological imaging of their lungs, of which two had multiple pulmonary cylindromas that were confirmed histologically. Serial computed tomography monitoring allowed for pre-emptive endobronchial laser ablation, preventing major airway obstruction and pulmonary collapse.

Conclusions: Pulmonary cylindromas are an unrecognized, but infrequently symptomatic, aspect of the phenotype in these patients that can have implications for patient care. They should be considered in patients with a high tumour burden that present with respiratory symptoms, and where appropriate, monitored with serial imaging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carrier State / diagnostic imaging
  • Carrier State / pathology*
  • DNA Mutational Analysis
  • Deubiquitinating Enzyme CYLD / genetics*
  • Dyspnea / etiology*
  • Female
  • Germ-Line Mutation
  • Humans
  • Lung / diagnostic imaging
  • Lung Neoplasms / complications
  • Lung Neoplasms / diagnostic imaging
  • Lung Neoplasms / genetics
  • Lung Neoplasms / secondary*
  • Male
  • Middle Aged
  • Neoplastic Syndromes, Hereditary / diagnostic imaging
  • Neoplastic Syndromes, Hereditary / genetics
  • Neoplastic Syndromes, Hereditary / pathology*
  • Retrospective Studies
  • Skin Neoplasms / diagnostic imaging
  • Skin Neoplasms / genetics
  • Skin Neoplasms / pathology*

Substances

  • CYLD protein, human
  • Deubiquitinating Enzyme CYLD

Supplementary concepts

  • Familial cylindromatosis