{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T03:46:24Z","timestamp":1773459984180,"version":"3.50.1"},"reference-count":58,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Vagal paraganglioma (VPGL) is a rare neuroendocrine tumor that originates from the paraganglion associated with the vagus nerve. VPGLs present challenges in terms of diagnostics and treatment. VPGL can occur as a hereditary tumor and, like other head and neck paragangliomas, is most frequently associated with mutations in the <jats:italic>SDHx<\/jats:italic> genes. However, data regarding the genetics of VPGL are limited. Herein, we report a rare case of a 41-year-old woman with VPGL carrying a germline variant in the <jats:italic>FH<\/jats:italic> gene. Using whole-exome sequencing, a variant, <jats:italic>FH<\/jats:italic> p.S249R, was identified; no variants were found in other PPGL susceptibility and candidate genes. Loss of heterozygosity analysis revealed the loss of the wild-type allele of the <jats:italic>FH<\/jats:italic> gene in the tumor. The pathogenic effect of the p.S249R variant on FH activity was confirmed by immunohistochemistry for S-(2-succino)cysteine (2SC). Potentially deleterious somatic variants were found in three genes, <jats:italic>SLC7A7<\/jats:italic>, <jats:italic>ZNF225<\/jats:italic>, and <jats:italic>MED23<\/jats:italic>. The latter two encode transcriptional regulators that can impact gene expression deregulation and are involved in tumor development and progression. Moreover, <jats:italic>FH<\/jats:italic>-mutated VPGL was characterized by a molecular phenotype different from <jats:italic>SDHx<\/jats:italic>-mutated PPGLs. In conclusion, the association of genetic changes in the <jats:italic>FH<\/jats:italic> gene with the development of VPGL was demonstrated. The germline variant <jats:italic>FH<\/jats:italic>: p.S249R and somatic deletion of the second allele can lead to biallelic gene damage that promotes tumor initiation. These results expand the clinical and mutation spectra of <jats:italic>FH<\/jats:italic>-related disorders and improve our understanding of the molecular genetic mechanisms underlying the pathogenesis of VPGL.<\/jats:p>","DOI":"10.3389\/fendo.2024.1381093","type":"journal-article","created":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T05:00:12Z","timestamp":1713934812000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Genetic changes in the FH gene cause vagal paraganglioma"],"prefix":"10.3389","volume":"15","author":[{"given":"Anastasiya V.","family":"Snezhkina","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vladislav S.","family":"Pavlov","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitry 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