Our verdict is Uncertain significance. Variant got 2 ACMG points: 2P and 0B. PM2
The NM_000548.5(TSC2):c.2167A>C(p.Ile723Leu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. 13/20 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. I723V) has been classified as Likely benign.
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]
Uncertain significance, criteria provided, single submitter
clinical testing
Ambry Genetics
Feb 28, 2023
The p.I723L variant (also known as c.2167A>C), located in coding exon 19 of the TSC2 gene, results from an A to C substitution at nucleotide position 2167. The isoleucine at codon 723 is replaced by leucine, an amino acid with highly similar properties. This amino acid position is not well conserved in available vertebrate species. In addition, the in silico prediction for this alteration is inconclusive. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -
Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);.;Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);.;Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);Loss of methylation at K720 (P = 0.0675);.;