Confirmed germline pathogenic / likely-pathogenic variant in FLCN (folliculin) — Birt-Hog...
Vista determinista de la entidad fuente YAML. La autoridad clínica sigue con los ID de fuente citados y estado de firma del revisor.
| ID | RF-BHD-FLCN-CONFIRMED-CARRIER |
|---|---|
| Tipo | Señal de alerta |
| Situación | reviewed 2026-05-20 | pending_clinical_signoff |
| Enfermedades | DIS-RCC |
| Fuentes | SRC-NCCN-GENETIC-FAMILIAL-BREAST-OVARIAN-2025 |
Origen de la bandera roja
| Definición | Confirmed germline pathogenic / likely-pathogenic variant in FLCN (folliculin) — Birt-Hogg-Dubé syndrome (BHD). Autosomal-dominant. Classic clinical triad: fibrofolliculomas (skin papules of face/neck/ upper trunk, often dermatologic presenting feature), pulmonary cysts + spontaneous pneumothorax (cumulative lifetime pneumothorax ~30-40%; imaging shows multiple basal/subpleural cysts), and renal cell carcinoma (~16-32% lifetime risk; characteristic chromophobe + hybrid oncocytic + clear-cell histologies; bilateral + multifocal common; often presents younger — 40s-50s — than sporadic RCC). FLCN encodes folliculin, an mTOR pathway regulator; loss-of-function variants cause BHD. Patient has confirmed positive germline test; no current personal cancer diagnosis in the carrier being assessed. Prevention-persona RedFlag (§20, v0.3 rare-hereditary expansion Wave P2). |
|---|---|
| Dirección clínica | investigación |
| Categoría | otros |
Lógica de activación
{
"any_of": [
{
"finding": "germline_flcn_pathogenic_variant_confirmed",
"value": true
},
{
"finding": "birt_hogg_dube_clinical_criteria_met",
"value": true
},
{
"finding": "bhd_fibrofolliculoma_phenotype_documented",
"value": true
}
],
"type": "lab_value"
}
Notas
Prevention-persona RedFlag for BHD/FLCN confirmed carriers. Multi- organ surveillance: abdominal MRI q2-3y from age 20 for RCC (avoid radiation; many BHD lesions are hybrid oncocytic + slow-growing); chest HRCT baseline + symptom-driven (spontaneous pneumothorax triggers high-resolution imaging); dermatology q1y for skin surveillance. Nephron-sparing surgery (partial nephrectomy) preferred for ≤3cm renal lesions given multifocal/bilateral disease pattern. STUB pending two-Co-Lead signoff per CHARTER §6.1 dev-mode.
Utilizado por
Indicación
IND-BHD-FLCN-CARRIER-OBSERVATION- IND-BHD-FLCN-CARRIER-OBSERVATIONIND-BHD-FLCN-CARRIER-SURVEILLANCE- IND-BHD-FLCN-CARRIER-SURVEILLANCE