Our verdict is Likely pathogenic. Variant got 6 ACMG points: 6P and 0B. PM2PP3_Strong
The NM_000548.5(TSC2):c.774G>C(p.Lys258Asn) variant causes a missense, splice region change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as not provided (no stars). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. K258Q) has been classified as Uncertain significance.
TSC2 (HGNC:12363): (TSC complex subunit 2) This gene is a tumor suppressor gene that encodes the growth inhibitory protein tuberin. Tuberin interacts with hamartin to form the TSC protein complex which functions in the control of cell growth. This TSC protein complex negatively regulates mammalian target of rapamycin complex 1 (mTORC1) signaling which is a major regulator of anabolic cell growth. Mutations in this gene have been associated with tuberous sclerosis and lymphangioleiomyomatosis. [provided by RefSeq, May 2022]
Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);.;Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);.;Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);Loss of ubiquitination at K258 (P = 0.0218);.;