Abstract
Several tumors, including uveal melanoma, show somatic mutations of GNAQ/GNA11. Circumscribed choroidal hemangioma is a benign tumor that becomes symptomatic in adulthood. In some patients, morphologic examination of biopsies is required for differential diagnosis between amelanotic choroidal melanoma and circumscribed choroidal hemangioma. Here, we report the results of GNAQ/GNA11 mutation analysis in samples from circumscribed choroidal hemangioma. Deep amplicon sequencing (Illumina MiSeq, San Diego, CA, USA) of positions R183 and Q209 of GNAQ and GNA11 in tissue samples from 33 patients with histologically diagnosed circumscribed choroidal hemangioma. All patients underwent biopsy or enucleation at our clinic between 2008 and 2018. To enable detection of variant alleles at low fractions, read depth exceeded 15,000-fold. DNA for genetic analysis was prepared from either snap-frozen (n = 22) or FFPE (n = 11) tissue samples. Samples from 28/33 patients (85%) showed a somatic missense mutation of GNAQ (c.626 A > G) predicted to result in p.Q209R. Variant allele fraction was variable (range 2.3% to 28%). Variants of GNAQ resulting in p.Q209 are characteristic for circumscribed choroidal hemangiomas. It appears that the GNAQ mutation spectrum in this tumor is narrow, possibly restricted to p.Q209R. Moreover, the spectrum is distinct from that of uveal melanoma, in which alterations resulting in p.Q209R are very rare.
Highlights
Circumscribed choroidal hemangioma (CCH) is a rare benign tumor that typically presents as a solitary orange-red mass, mostly temporal at the posterior pole of the fundus
Variants of GNAQ resulting in p.Q209 are characteristic for circumscribed choroidal hemangiomas
In a third patient with clinical diagnosis of hemangioma, the eye had to be enucleated for curative reasons
Summary
Circumscribed choroidal hemangioma (CCH) is a rare benign tumor that typically presents as a solitary orange-red mass, mostly temporal at the posterior pole of the fundus. It usually becomes symptomatic in adulthood (between the second and fourth decade) when subretinal or intraretinal fluid within the macula region or exudative retinal detachment cause visual problems [1,2,3]. FLA of CCH typically shows pre-arterial filling of the tumor vessels during the first few seconds of fluorescein angiography, while in late phase, a wash-out is observed [4]
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