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Objectives: Lung metastasizing leiomyomatosis (LML) is an infrequently diagnosed pathology developed after sexual maturation, commonly preceded by uterine myomas. Symptoms can include difficulties to breathe, cough, dyspnea and pain, because of mechanical obstruction exerted by expanding local growing leiomyomas. Lung leiomyomas are normally detected by imaging studies, but nowadays the precise diagnosis demands histological characterization of biopsies obtained from the affected tissues. The purpose of the present study was to determine the presence of genomic alterations in circulating cells of LML. Methods: Immunohistochemical characterization of a lung biopsy extracted by thoracoscopy was performed. Pathologic proliferative smooth muscle cells were observed in a major lung metastasizing nodule, with a growing pattern similar to a uterine myoma. The presence of cellular linages different to smooth muscle cells was discarded by testing the presence of a battery of molecular markers. Also, a normal karyotype was determine by GTG‐banding cytogenetic study, but a high density microarray analysis revealed six submicroscopic chromosomal regions displaying genomic abnormalities: microduplications were detected on chromosomes 4, 14, 17 and 22; and microdeletions on chromosomes 8 and 10. Conclusion: This study remarks the relevance of submicroscopic chromosomal analysis of unusual pathologic conditions such as Benign Metastasizing Leiomyomatosis. This propitiate a better understanding of the molecular basis on the development of the pathology, in order to reckon on minimally invasive diagnostic methods, and to design appropriate treatments. [ABSTRACT FROM AUTHOR]

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Genetic counseling is an information process to help people in the understanding and adaptation to the medical, psychological and family implications of the genetic contribution in diseases. This counseling encompasses all sorts of patients. This represents a challenge in the daily work of the medical geneticist, because giving information in a meaningful way to the patient and his family implies an emotional and psychological burden. Generally we can see two outcomes in the medical practice of genetics, which converge after a diagnosis process: 1) we can face the inability to reach a diagnostic conclusion or 2) we can establish or confirm a diagnosis with certainty, which is the main piece in the genetic counseling. However, in all the situations the uncertainty is a fact, since in the case of those individuals who come in for genetic counseling before symptoms appear or those in prenatal cases, the absence of clinical manifestations and the impossibility to change the course of events lead to the appearance of helplessness and despair. In those cases without diagnostic conclusion, this situation represents a reason for uncertainty, and even in those patients with a diagnosis, certain factors can modify the circumstances in which genetic counseling occurs, such as unpredictability or lack of control. Therefore, it is important to consider the management of uncertainty as an inherent part throughout the process of care in medical genetics. The teaching of medical genetics should also consider the inclusion of topics related to this circumstance. [ABSTRACT FROM AUTHOR]

The work of the medical geneticist is, from the clinical point of view, scarcely known. His healthcare-related activity requires close collaboration with specialists in different fields; hence, it is vital for the physician directly in charge of the patient to have at hand some useful recommendations in order to make care provided by the multidisciplinary team efficient and timely. The purpose of this paper is to outline some of the professional features of medical genetics specialists and to describe, in general terms, the work in clinical genetics, as well as to inform first contact clinicians -- especially pediatricians -- about the clinical and imaging studies they should order for patients with the most common congenital conditions before referring them for diagnostic or genetic counseling. It is important to point out that the communication process between the treating clinician and his/her patients (which in pediatric patients is with the family) is essential not only with regard to the reason for referral to the medical genetics department, but also for the family to be able to obtain information prior to the appointment, so that time and quality of care are improved once the genetics consultation takes place. Finally, this manuscript outlines the requirements for the communication between specialists, in order for them to promote and provide knowledge on medical genetics at all levels of care, for the benefit of patients. [ABSTRACT FROM AUTHOR]

Genetic counseling is an information process to help people in the understanding and adaptation to the medical, psychological and family implications of the genetic contribution in diseases. This counseling encompasses all sorts of patients. This represents a challenge in the daily work of the medical geneticist, because giving information in a meaningful way to the patient and his family implies an emotional and psychological burden. Generally we can see two outcomes in the medical practice of genetics, which converge after a diagnosis process: 1) we can face the inability to reach a diagnostic conclusion or 2) we can establish or confirm a diagnosis with certainty, which is the main piece in the genetic counseling. However, in all the situations the uncertainty is a fact, since in the case of those individuals who come in for genetic counseling before symptoms appear or those in prenatal cases, the absence of clinical manifestations and the impossibility to change the course of events lead to the appearance of helplessness and despair. In those cases without diagnostic conclusion, this situation represents a reason for uncertainty, and even in those patients with a diagnosis, certain factors can modify the circumstances in which genetic counseling occurs, such as unpredictability or lack of control. Therefore, it is important to consider the management of uncertainty as an inherent part throughout the process of care in medical genetics. The teaching of medical genetics should also consider the inclusion of topics related to this circumstance.

The work of the medical geneticist is, from the clinical point of view, scarcely known. His healthcare-related activity requires close collaboration with specialists in different fields; hence, it is vital for the physician directly in charge of the patient to have at hand some useful recommendations in order to make care provided by the multidisciplinary team efficient and timely. The purpose of this paper is to outline some of the professional features of medical genetics specialists and to describe, in general terms, the work in clinical genetics, as well as to inform first contact clinicians - especially pediatricians - about the clinical and imaging studies they should order for patients with the most common congenital conditions before referring them for diagnostic or genetic counseling. It is important to point out that the communication process between the treating clinician and his/her patients (which in pediatric patients is with the family) is essential not only with regard to the reason for referral to the medical genetics department, but also for the family to be able to obtain information prior to the appointment, so that time and quality of care are improved once the genetics consultation takes place. Finally, this manuscript outlines the requirements for the communication between specialists, in order for them to promote and provide knowledge on medical genetics at all levels of care, for the benefit of patients.

Introduction: Multiple familial cancer is a rare entity as is also Li-Fraumeni Syndrome (LFS), which involves a mutation in the germ cell line of Tp53 suppresor gene that is expressed in chromosome 17p13.1 and occurs as an autosomal dominant condition., Objective: Presentation of one case of LFS., Clinical Case: Family history: maternal grandfather had melanoma and maternal aunt had osteoblastic osteosarcoma of the left distal femur. Eight-and-a-half year-old child with a history of a CNS tumor (choroid plexus carcinoma) and two years later, a melanoma (Spitz nevus)., Symptoms: impaired motor function of the left half of the body and pain upon ipsilateral gait. The physical exam showed swelling of the left iliac crest. The X-rays showed osteoblastic osteosarcoma and the fine needle aspiration biopsy (FNAB) was positive. The diagnosis was made according to the clinical criteria for LFS., Discussion: We report a case of LFS diagnosed based on clinical criteria. We suggest that the questioning of patients with cancer be aimed at finding out the family history of neoplasias. The case presented herein shows an evident association between both choroid plexus carcinoma and osteoblastic osteosarcoma and the patient's family history. We think that any physician treating children with cancer should consider these multiple familial cancer syndromes.