rs1554897280
Variant summary
Our verdict is Pathogenic. The variant received 12 ACMG points: 12P and 0B. PVS1_ModeratePM2PP5_Very_Strong
The NM_000314.8(PTEN):c.209+1G>A variant causes a splice donor, intron 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 Likely pathogenic (★★).
Frequency
Consequence
NM_000314.8 splice_donor, intron
Scores
Clinical Significance
Conservation
Publications
- Cowden syndrome 1Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae), G2P
- PTEN hamartoma tumor syndromeInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- macrocephaly-autism syndromeInheritance: AD Classification: STRONG, SUPPORTIVE Submitted by: Ambry Genetics, Genomics England PanelApp, Orphanet
- renal cell carcinomaInheritance: AD Classification: MODERATE Submitted by: Genomics England PanelApp
- leiomyosarcomaInheritance: AR Classification: MODERATE Submitted by: Genomics England PanelApp
- activated PI3K-delta syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Bannayan-Riley-Ruvalcaba syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Cowden diseaseInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Lhermitte-Duclos diseaseInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- Proteus-like syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- glioma susceptibility 2Inheritance: AD Classification: LIMITED Submitted by: Ambry Genetics
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ACMG classification
Our verdict: Pathogenic. The variant received 12 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt | 
|---|---|---|---|---|---|---|---|---|
| PTEN | NM_000314.8 | c.209+1G>A | splice_donor_variant, intron_variant | Intron 3 of 8 | ENST00000371953.8 | NP_000305.3 | ||
| PTEN | NM_001304717.5 | c.728+1G>A | splice_donor_variant, intron_variant | Intron 4 of 9 | NP_001291646.4 | |||
| PTEN | NM_001304718.2 | c.-541-5488G>A | intron_variant | Intron 2 of 8 | NP_001291647.1 | 
Ensembl
Frequencies
GnomAD3 genomes  
GnomAD4 exome Data not reliable, filtered out with message: AC0 AF:  0.00  AC: 0AN: 1414990Hom.:  0  Cov.: 29 AF XY:  0.00  AC XY: 0AN XY: 705560 
GnomAD4 genome  
ClinVar
Submissions by phenotype
PTEN hamartoma tumor syndrome    Pathogenic:2 
This sequence change affects a donor splice site in intron 3 of the PTEN gene. RNA analysis indicates that disruption of this splice site induces altered splicing and likely results in a shortened protein product. This variant is not present in population databases (gnomAD no frequency). Disruption of this splice site has been observed in individuals with clinical features of PTEN-related conditions (PMID: 10234502, 10400993, 17526801, 21194675, 21659347, 23335809). This variant is also known as IVS3+1G>A. ClinVar contains an entry for this variant (Variation ID: 418434). Studies have shown that disruption of this splice site results in skipping of exon 3, but is expected to preserve the integrity of the reading-frame (PMID: 16014636). For these reasons, this variant has been classified as Pathogenic. -
ACMG criteria used (ClinGen PTEN Expert Panel Specifications to the ACMG/AMP Variant Interpretation Guidelines for PTEN Version 3.1.0): PVS1_Strong, PM2_Supporting, PP3. -
Prostate cancer;C1854416:Macrocephaly-autism syndrome;C2751642:Glioma susceptibility 2;C3551915:Familial meningioma;CN072330:Cowden syndrome 1    Pathogenic:1 
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Familial meningioma    Pathogenic:1 
This variant was classified as: Pathogenic. The following ACMG criteria were applied in classifying this variant: PVS1,PM2,PP3,PP5. -
not provided    Pathogenic:1 
Canonical splice site variant demonstrated to result in exon 3 skipping, resulting in an in-frame deletion disrupting the critical phosphatase domain and an ATP binding region (Agrawal 2005, Lobo 2009, Molinari 2014); Not observed in large population cohorts (Lek 2016); This variant is associated with the following publications: (PMID: 25525159, 11071384, 15372512, 12938083, 14518068, 17526801, 10400993, 16014636, 24475377, 19457929, 26582918, 28677221) -
Hereditary cancer-predisposing syndrome    Pathogenic:1 
The c.209+1G>A intronic pathogenic mutation results from a G to A substitution one nucleotide after coding exon 3 of the PTEN gene. Alterations that disrupt the canonical splice site are expected to result in aberrant splicing. In silico splice site analysis predicts that this alteration will weaken the native splice donor site. RNA studies have demonstrated that this alteration results in abnormal splicing in the set of samples tested (Ambry internal data). The resulting transcript is predicted to be in-frame and is not expected to trigger nonsense-mediated mRNA decay; however, direct evidence is unavailable. The exact functional effect of the altered amino acid sequence is unknown; however, the impacted region is critical for protein function (Ambry internal data). Functional analysis using patient mRNA has shown that this transcript has significantly reduced protein phosphatase activity despite being in-frame and stable due to exon 3 skipping (Agrawal S et al. Hum Mol Genet, 2005 Aug;14:2459-68). Moreover, this alteration has been reported in a individual with presumed sporadic Bannayan-Riley-Ruvalcaba syndrome (BRRS) (Marsh DJ et al. Hum. Mol. Genet., 1999 Aug;8:1461-72) and in cohorts of patients with features of Cowden syndrome (CS) and/or BRRS (Pilarski R et al. J Med Genet, 2011 Aug;48:505-12; Tan MH et al. Am J Hum Genet. 2011 Jan;88(1):42-56). Specifically, this mutation was identified in an 11-year-old female with macrocephaly, vascular anomalies, lipoma, and Graves disease (Tan WH et al. J Med Genet, 2007 Sep;44:594-602). Another alteration impacting the same donor site (c.209+4A>G) has been shown to have a similar impact on splicing in an individual diagnosed with breast and endometrial cancer at less than 50 years of age (Ambry internal data). Of note, this alteration is also designated as IVS3+1G>A in published literature. This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -
Computational scores
Source: 
Splicing
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at