Recurrent ganglioneuroma in PTPN11-associated Noonan syndrome: A case report and literature review

Joel A. Morales-Rosado, Herchran Singh, Rory J. Olson, Brandon T. Larsen, Megan M. Hager, Eric W. Klee, Radhika Dhamija

Research output: Contribution to journalArticlepeer-review


Noonan syndrome (NS) is an autosomal dominant condition with variable expressivity most commonly due to a germline pathogenic variant in PTPN11, which encodes the protein tyrosine phosphatase SHP-2. Gain-of-function variants in PTPN11 are known to promote oncogenic behavior in affected tissues. We report the clinical description of a young adult male presenting with relapsing ganglioneuromas, dysmorphic features, cardiac abnormalities, and multiple lentigines, strongly suspicious for NS. Solid tumor testing identified the recurrent pathogenic c.922G>A (p.Asn308Asp) in PTPN11. Proband and parental blood sampling testing confirmed c.922G>A as a de novo germline alteration. Comprehensive literature review of solid tumors specifically associated to PTPN11, indicates that this is the first documentation of ganglioneuroma and its clinical recurrence after resection in conjunction with a genetically confirmed NS diagnosis. The findings in our patient further extend the list of neuroblastic and neural crest-derived neoplasms associated with this condition.

Original languageEnglish (US)
Pages (from-to)1883-1887
Number of pages5
JournalAmerican Journal of Medical Genetics, Part A
Issue number6
StatePublished - Jun 2021


  • Noonan
  • PTPN11
  • ganglioneuroma
  • neoplasia

ASJC Scopus subject areas

  • Genetics
  • Genetics(clinical)


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