Autosomal‐dominant myopathic disorder associated with diaphyseal medullary stenosis with malignant fibrous
hisocytoma (DMS‐MFH) is characterized by myopathy, bone fragility, and osteosarcoma. DMS‐MFH was recently
associated with mutaons in the methylthioadenosine phosphorylase gene (MTAP). MTAP is a ubiquitously expressed enzyme crucial for polyamine biosynthesis. Two disease‐causing mutaons have been idenfied in MTAP: c.813‐2A>G and c.885A>G, both of which result in dysregulated alternave splicing of MTAP isoforms. Here, we report on myopathy in two cousins with the c.813‐2A>G mutaon. Both developed a progressive limb‐girdle type myopathy at age 30 years. To our knowledge, we are the first group to characterize the myopathy associated with DMS‐MFH, discovering varied muscle fiber size, degeneraon, and increased centralized nuclei. In this report, expression levels of transacve response DNA‐binding protein (TDP)‐43, light chain (LC)3‐I/II, and p62/sequestome 1 (SQSTM1) in the muscle fibers were increased, suggesng a possible dysregulaon of autophagy. Elucidaon of the pathologic mechanism(s) in DMS‐MFH offers the potenal to uncover key molecular signaling pathways and the promise of novel future treatments.