Arup #2002726 PTEN deletion/duplication

Message
Diagnostic testing for PTEN-related disorders. Predictive testing for PTEN-related disorders


Test Code
2002726


Alias/See Also
PTENDELDUP


Preferred Specimen
3 mL whole blood.


Minimum Volume
1 mL


Transport Container
Lavender (EDTA), pink (K2EDTA), or yellow (ACD Solution A or B).


Transport Temperature
Refrigerated.


Specimen Stability
Ambient: 72 hours; Refrigerated: 1 week


Reject Criteria (Eg, hemolysis? Lipemia? Thaw/Other?)
Frozen


Methodology
Polymerase Chain Reaction/Multiplex Ligation-dependent Probe Amplification

Report Available
Within 14 days


Clinical Significance
"Background Information for PTEN-Related Disorders (PTEN)Deletion/Duplication:
Characteristics of PTEN hamartoma tumor syndrome (PHTS): Clinical findings are highly variable and include Cowden syndrome (CS), Bannayan-Riley-Ruvalcaba syndrome (BRRS), Proteus syndrome (PS) and Proteus-like syndrome (PSL).
CS: Multiple hamartoma syndrome with increased risk for malignant and benign tumors of the breast, thyroid and endometrium. Other associated findings include macrocephaly and mucocutaneous lesions (facial trichilemmomas, palmoplantar keratoses and papillomatous papules).
BRRS: Characterized by macrocephaly, intestinal hamartomatous polyposis, lipomas, hemangiomas and pigmented macules of the glans penis.
PS: A progressive disorder demonstrating mosaic distribution of associated lesions. Findings include hamartomatous tissue overgrowth, hyperostoses, connective tissue and epidermal nevi, dysregulated adipose tissue, vascular malformations and other congenital malformations.
PSL: Describes individuals with significant features of PS who do not meet clinical diagnostic criteria for PS.
Incidence: At least 1 in 200,000 for CS; PS is rare with approximately 120 reported cases; unknown for other PTEN-associated conditions.
Inheritance: Autosomal dominant. All mutations causing PS and 50-90 percent causing CS are de novo.
Penetrance: 99 percent by 30 years of age for CS.
Cause: Pathogenic PTEN gene mutations.
Clinical Sensitivity: Up to 10 percent for BRRS; unknown for CS, PS, and PSL.
Methodology: Multiplex ligation-dependent probe amplification (MLPA) to detect large PTEN coding region deletions/duplications.
Analytical Sensitivity and Specificity of MLPA: 90 and 98 percent, respectively.
Limitations: Diagnostic errors can occur due to rare sequence variations. PTEN single base pair substitutions, small deletions/duplications, regulatory region mutations, deep intronic mutations, and large deletions of single exon 3 will not be detected. Deletion/duplication breakpoints will not be determined.
Counseling and informed consent are recommended for genetic testing. Consent forms are available online at www.aruplab.co
"




The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. CPT coding is the sole responsibility of the billing party. Please direct any questions regarding coding to the payor being billed. Any Profile/panel component may be ordered separately. Reflex tests are performed at an additional charge.