Somatic HIF2A gain-of-function mutations in paraganglioma with polycythemia

N Engl J Med. 2012 Sep 6;367(10):922-30. doi: 10.1056/NEJMoa1205119.


Hypoxia-inducible factors are transcription factors controlling energy, iron metabolism, erythropoiesis, and development. When these proteins are dysregulated, they contribute to tumorigenesis and cancer progression. However, mutations in genes encoding α subunits of hypoxia-inducible factors (HIF-α) have not previously been identified in any cancer. Here we report two novel somatic gain-of-function mutations in the gene encoding hypoxia-inducible factor 2α (HIF2A) in two patients, one presenting with paraganglioma and the other with paraganglioma and somatostatinoma, both of whom had polycythemia. The two mutations were associated with increased HIF-2α activity and increased protein half-life.

Publication types

  • Case Reports
  • Research Support, N.I.H., Intramural

MeSH terms

  • Abdominal Neoplasms / complications
  • Abdominal Neoplasms / genetics*
  • Adolescent
  • Adrenal Gland Neoplasms / complications
  • Adrenal Gland Neoplasms / genetics*
  • Adult
  • Basic Helix-Loop-Helix Transcription Factors / genetics*
  • Basic Helix-Loop-Helix Transcription Factors / metabolism
  • DNA Mutational Analysis
  • Female
  • Humans
  • Hydroxylation
  • Mutation
  • Pancreatic Neoplasms / genetics
  • Paraganglioma / blood
  • Paraganglioma / complications
  • Paraganglioma / genetics*
  • Polycythemia / etiology*
  • Somatostatinoma / complications
  • Somatostatinoma / genetics*
  • Transcription, Genetic
  • Up-Regulation


  • Basic Helix-Loop-Helix Transcription Factors
  • endothelial PAS domain-containing protein 1