CATSPER3
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Also known as CACRC
Summary
CATSPER3 (cation channel sperm associated 3, HGNC:20819) is a protein-coding gene on chromosome 5q31.1, encoding Cation channel sperm-associated protein 3 (Q86XQ3). Pore-forming subunit of the CatSper complex, a sperm-specific voltage-gated calcium channel that plays a central role in calcium-dependent physiological responses essential for successful fertilization, such as sperm hyperactivation, acrosome reaction and chemotaxis towards the….
Predicted to enable voltage-gated calcium channel activity. Predicted to be involved in flagellated sperm motility; sodium ion transport; and sperm capacitation. Predicted to act upstream of or within establishment of localization in cell. Predicted to be located in plasma membrane. Predicted to be part of CatSper complex. Predicted to be active in acrosomal vesicle.
Source: NCBI Gene 347732 — RefSeq curated summary.
At a glance
- GWAS associations: 12
- Clinical variants (ClinVar): 67 total
- MANE Select transcript:
NM_178019
Identifiers
Gene identifiers
| Field | Value |
|---|---|
| HGNC ID | HGNC:20819 |
| Approved symbol | CATSPER3 |
| Name | cation channel sperm associated 3 |
| Location | 5q31.1 |
| Locus type | gene with protein product |
| Status | Approved |
| Aliases | CACRC |
| Ensembl gene | ENSG00000152705 |
| Ensembl biotype | protein_coding |
| OMIM | 609120 |
| Entrez | 347732 |
Gene structure
Transcript identifiers
Ensembl transcripts: 2 — 1 protein_coding, 1 protein_coding_CDS_not_defined
ENST00000282611, ENST00000511235
RefSeq mRNA: 1 — MANE Select: NM_178019
NM_178019
CCDS: CCDS4181
Canonical transcript exons
ENST00000282611 — 8 exons
| Exon | Start | End |
|---|---|---|
| ENSE00001085869 | 135009371 | 135009490 |
| ENSE00001085870 | 135008841 | 135008981 |
| ENSE00001293518 | 135010373 | 135010530 |
| ENSE00001298298 | 134967907 | 134968089 |
| ENSE00001310489 | 135011521 | 135011696 |
| ENSE00001317445 | 135007957 | 135008139 |
| ENSE00003520969 | 134969939 | 134970092 |
| ENSE00003659626 | 134996273 | 134996512 |
Expression profiles
Bgee: expression breadth ubiquitous, 162 present calls, max score 90.30.
FANTOM5 (CAGE): breadth tissue_specific, TPM avg 0.0314 / max 28.8694, expressed in 4 samples.
FANTOM5 promoters (2 alternative TSS)
| Promoter ID | TPM avg | Samples expressed |
|---|---|---|
| 58635 | 0.0215 | 4 |
| 58634 | 0.0098 | 3 |
Top tissues by expression
248 total, by Bgee expression score (0-100, higher = more expressed):
| Tissue | Anatomy ID | Expression score | Quality |
|---|---|---|---|
| sperm | CL:0000019 | 90.30 | gold quality |
| right testis | UBERON:0004534 | 87.79 | gold quality |
| left testis | UBERON:0004533 | 87.72 | gold quality |
| male germ line stem cell (sensu Vertebrata) in testis | CL:0000089 ∩ UBERON:0000473 | 86.62 | gold quality |
| testis | UBERON:0000473 | 85.72 | gold quality |
| primordial germ cell in gonad | CL:0000670 ∩ UBERON:0000991 | 75.90 | gold quality |
| adult organism | UBERON:0007023 | 73.11 | gold quality |
| gastrocnemius | UBERON:0001388 | 70.47 | gold quality |
| muscle of leg | UBERON:0001383 | 70.19 | gold quality |
| hindlimb stylopod muscle | UBERON:0004252 | 69.99 | gold quality |
| lower esophagus mucosa | UBERON:0035834 | 68.84 | gold quality |
| right uterine tube | UBERON:0001302 | 67.64 | gold quality |
| mucosa of transverse colon | UBERON:0004991 | 67.43 | gold quality |
| mucosa of stomach | UBERON:0001199 | 67.32 | gold quality |
| right lobe of liver | UBERON:0001114 | 67.17 | gold quality |
| tibialis anterior | UBERON:0001385 | 64.85 | silver quality |
| body of pancreas | UBERON:0001150 | 63.28 | gold quality |
| tibial artery | UBERON:0007610 | 62.21 | gold quality |
| popliteal artery | UBERON:0002250 | 62.20 | gold quality |
| esophagogastric junction muscularis propria | UBERON:0035841 | 61.87 | gold quality |
| granulocyte | CL:0000094 | 61.79 | gold quality |
| ventricular zone | UBERON:0003053 | 61.54 | gold quality |
| skeletal muscle tissue of biceps brachii | UBERON:0004502 | 61.51 | gold quality |
| minor salivary gland | UBERON:0001830 | 61.39 | gold quality |
| adenohypophysis | UBERON:0002196 | 61.27 | gold quality |
| pancreas | UBERON:0001264 | 61.14 | gold quality |
| body of stomach | UBERON:0001161 | 60.71 | gold quality |
| esophagus mucosa | UBERON:0002469 | 60.63 | gold quality |
| deltoid | UBERON:0001476 | 60.50 | gold quality |
| right adrenal gland | UBERON:0001233 | 60.25 | gold quality |
Single-cell (SCXA)
Detected in 1 experiment(s), a significant marker in 0.
| Experiment | Marker? | Max mean expression |
|---|---|---|
| E-ANND-3 | no | 1.25 |
Regulation
Is transcription factor: no
Literature-anchored findings (GeneRIF, showing 2)
- PMID: 12646162 concludes Alu repeats interfere with splicing of DCOHM and CAVL such that transcripts containing exons of both genes exist. (PMID:12646162)
- Catsper3 has a single channel-forming domain, a pore-loop with the consensus sequence TxDxW, & a coiled-coil protein-protein interaction domain in the C-terminal tail. CatSpers 1,2,3 & 4 may interact directly or indirectly to form a functional tetramer. (PMID:12932298)
Cross-species orthologs
2 orthologs
| Organism | Symbol | Gene ID |
|---|---|---|
| mus_musculus | Catsper3 | ENSMUSG00000021499 |
| rattus_norvegicus | Catsper3 | ENSRNOG00000011374 |
Paralogs (26): CACNA1G (ENSG00000006283), SCN4A (ENSG00000007314), CACNA1S (ENSG00000081248), CACNA1I (ENSG00000100346), CACNA1F (ENSG00000102001), NALCN (ENSG00000102452), SCN2A (ENSG00000136531), SCN7A (ENSG00000136546), CACNA1A (ENSG00000141837), SCN1A (ENSG00000144285), CACNA1B (ENSG00000148408), CACNA1C (ENSG00000151067), SCN3A (ENSG00000153253), CACNA1D (ENSG00000157388), TPCN2 (ENSG00000162341), CATSPER2 (ENSG00000166762), SCN11A (ENSG00000168356), SCN9A (ENSG00000169432), CATSPER1 (ENSG00000175294), SCN5A (ENSG00000183873), SCN10A (ENSG00000185313), TPCN1 (ENSG00000186815), CATSPER4 (ENSG00000188782), CACNA1H (ENSG00000196557), SCN8A (ENSG00000196876), CACNA1E (ENSG00000198216)
Protein
Protein identifiers
Cation channel sperm-associated protein 3 — Q86XQ3 (reviewed: Q86XQ3)
Alternative names: Ca(v)-like protein, One-repeat calcium channel-like protein
All UniProt accessions (1): Q86XQ3
UniProt curated annotations — full annotation on UniProt →
Function. Pore-forming subunit of the CatSper complex, a sperm-specific voltage-gated calcium channel that plays a central role in calcium-dependent physiological responses essential for successful fertilization, such as sperm hyperactivation, acrosome reaction and chemotaxis towards the oocyte.
Subunit / interactions. Component of the CatSper complex or CatSpermasome composed of the core pore-forming members CATSPER1, CATSPER2, CATSPER3 and CATSPER4 as well as auxiliary members CATSPERB, CATSPERG, CATSPERD, CATSPERE, CATSPERZ, CATSPERT, CATSPERQ, CATSPERH and EFCAB9. HSPA1 may be an additional auxiliary complex member. The core complex members CATSPER1, CATSPER2, CATSPER3 and CATSPER4 form a heterotetrameric channel. The auxiliary CATSPERB, CATSPERG, CATSPERD and CATSPERE subunits form a pavilion-like structure over the pore which stabilizes the complex through interactions with CATSPER4, CATSPER3, CATSPER1 and CATSPER2 respectively. CATSPERH interacts with CATSPERB, further stabilizing the complex. CATSPERT interacts at least with CATSPERD and is required for targeting the CatSper complex in the flagellar membrane.
Subcellular location. Cell projection. Cilium. Flagellum membrane.
Tissue specificity. Testis-specific.
Activity regulation. The CatSper calcium channel is indirectly activated by extracellular progesterone and prostaglandins following the sequence: progesterone > PGF1-alpha = PGE1 > PGA1 > PGE2 » PGD2. The CatSper calcium channel is directly inhibited by endocannabinoid 2-arachidonoylglycerol (2AG). Indirect activation by progesterone takes place via the following mechanism: progesterone binds and activates the acylglycerol lipase ABHD2, which in turn mediates hydrolysis of 2AG inhibitor, relieving inhibition of the CatSper channel. The primary effect of progesterone activation is to shift voltage dependence towards more physiological, negative membrane potentials; it is not mediated by metabotropic receptors and second messengers. Sperm capacitation enhances the effect of progesterone by providing additional negative shift. Also activated by the elevation of intracellular pH.
Similarity. Belongs to the cation channel sperm-associated (TC 1.A.1.19) family.
RefSeq proteins (1): NP_821138* (*=MANE)
Domains & families (InterPro)
| ID | Name | Type |
|---|---|---|
| IPR005821 | Ion_trans_dom | Domain |
| IPR027359 | Volt_channel_dom_sf | Homologous_superfamily |
Pfam: PF00520
Catalyzed reactions (Rhea), 1 shown:
- Ca(2+)(in) = Ca(2+)(out) (RHEA:29671)
UniProt features (17 total): topological domain 8, transmembrane region 6, chain 1, intramembrane region 1, sequence variant 1
Structure
Experimental structures (PDB)
0 structures.
Predicted structure (AlphaFold)
| Model | pLDDT | Fraction very-high |
|---|---|---|
| AF-Q86XQ3-F1 | 80.01 | 0.27 |
Function
Pathways and Gene Ontology
Reactome pathways
1 pathways
| ID | Pathway |
|---|---|
| R-HSA-1300642 | Sperm Motility And Taxes |
MSigDB gene sets: 72 (showing top):
GOCC_SECRETORY_GRANULE, DARWICHE_PAPILLOMA_PROGRESSION_RISK, GOBP_MALE_GAMETE_GENERATION, GOBP_MONOATOMIC_CATION_TRANSPORT, GOBP_SPERM_CAPACITATION, GOBP_ANATOMICAL_STRUCTURE_MATURATION, GOBP_CELL_MATURATION, GOBP_CILIUM_MOVEMENT, GOBP_CILIUM_OR_FLAGELLUM_DEPENDENT_CELL_MOTILITY, GOBP_CELLULAR_PROCESS_INVOLVED_IN_REPRODUCTION_IN_MULTICELLULAR_ORGANISM, WEBER_METHYLATED_LCP_IN_SPERM_UP, GOBP_DEVELOPMENTAL_PROCESS_INVOLVED_IN_REPRODUCTION, GOBP_CALCIUM_ION_TRANSMEMBRANE_TRANSPORT, GOBP_TRANSMEMBRANE_TRANSPORT, GOBP_SODIUM_ION_TRANSPORT
GO Biological Process (11): sodium ion transport (GO:0006814), flagellated sperm motility (GO:0030317), sperm capacitation (GO:0048240), establishment of localization in cell (GO:0051649), monoatomic ion transport (GO:0006811), calcium ion transport (GO:0006816), spermatogenesis (GO:0007283), cell differentiation (GO:0030154), monoatomic ion transmembrane transport (GO:0034220), transmembrane transport (GO:0055085), calcium ion transmembrane transport (GO:0070588)
GO Molecular Function (3): voltage-gated calcium channel activity (GO:0005245), monoatomic ion channel activity (GO:0005216), calcium channel activity (GO:0005262)
GO Cellular Component (11): acrosomal vesicle (GO:0001669), endoplasmic reticulum (GO:0005783), plasma membrane (GO:0005886), CatSper complex (GO:0036128), sperm midpiece (GO:0097225), sperm principal piece (GO:0097228), cilium (GO:0005929), membrane (GO:0016020), motile cilium (GO:0031514), monoatomic ion channel complex (GO:0034702), cell projection (GO:0042995)
Reactome top-level categories
Rollup of top-1 pathways:
| Category | Pathways |
|---|---|
| Fertilization | 1 |
GO top-level categories
Rollup of top GO terms by namespace:
| Category | Terms |
|---|---|
| cellular anatomical structure | 4 |
| metal ion transport | 2 |
| developmental process involved in reproduction | 2 |
| transport | 2 |
| sperm flagellum | 2 |
| cilium-dependent cell motility | 1 |
| cilium movement involved in cell motility | 1 |
| sperm motility | 1 |
| spermatid development | 1 |
| cellular process involved in reproduction in multicellular organism | 1 |
| cell maturation | 1 |
| establishment of localization | 1 |
| cellular localization | 1 |
| male gamete generation | 1 |
| cellular developmental process | 1 |
| monoatomic ion transport | 1 |
| transmembrane transport | 1 |
| cellular process | 1 |
| calcium ion transport | 1 |
| monoatomic cation transmembrane transport | 1 |
| calcium channel activity | 1 |
| voltage-gated monoatomic cation channel activity | 1 |
| monoatomic ion transmembrane transporter activity | 1 |
| channel activity | 1 |
| monoatomic cation channel activity | 1 |
| calcium ion transmembrane transporter activity | 1 |
| secretory granule | 1 |
| cytoplasm | 1 |
| endomembrane system | 1 |
| intracellular membrane-bounded organelle | 1 |
| membrane | 1 |
| cell periphery | 1 |
| voltage-gated calcium channel complex | 1 |
| intraciliary transport particle | 1 |
| membrane-bounded organelle | 1 |
| plasma membrane bounded cell projection | 1 |
| cilium | 1 |
| transmembrane transporter complex | 1 |
Protein interactions and networks
STRING
922 interactions, top by confidence (×1000):
| Protein A | Protein B | Partner UniProt | Score |
|---|---|---|---|
| CATSPER3 | PCBD2 | Q9H0N5 | 935 |
| CATSPER3 | CATSPERB | Q9H7T0 | 795 |
| CATSPER3 | CATSPERD | Q86XM0 | 781 |
| CATSPER3 | EFCAB9 | A8MZ26 | 740 |
| CATSPER3 | CATSPER2 | Q96P56 | 727 |
| CATSPER3 | CATSPER4 | Q7RTX7 | 705 |
| CATSPER3 | CATSPERE | Q5SY80 | 673 |
| CATSPER3 | CATSPER1 | Q8NEC5 | 635 |
| CATSPER3 | CATSPERZ | Q9NTU4 | 623 |
| CATSPER3 | OR52W1 | Q6IF63 | 573 |
| CATSPER3 | CCDC185 | Q8N715 | 568 |
| CATSPER3 | TXNDC15 | Q96J42 | 564 |
| CATSPER3 | CATSPERG | Q6ZRH7 | 548 |
| CATSPER3 | MSANTD1 | Q6ZTZ1 | 532 |
| CATSPER3 | SLC9C1 | Q4G0N8 | 525 |
IntAct
0 interactions, top by confidence:
ESM2 similar proteins: A2ARP9, B1AYL1, D0E0C2, F1LQQ7, O08562, O14234, O35505, O43497, O46669, O54898, O55017, O73700, O88457, P02719, P0DMA5, P15381, P15390, P22002, P27732, P50077, P56698, P56699, P59111, Q01118, Q02294, Q02343, Q07652, Q13936, Q15858, Q15878, Q28371, Q28644, Q61290, Q62205, Q62968, Q6AXP6, Q6QIY3, Q7RTX7, Q80W99, Q86XQ3
Diamond homologs: O95180, Q80W99, Q86XQ3, O57483
SIGNOR signaling
1 interactions.
| A | Effect | B | Mechanism |
|---|---|---|---|
| CATSPER3 | “form complex” | “CatSpermasome complex” | binding |
Disease & clinical
Clinical variants and AI predictions
ClinVar
67 variants total. Per-class counts are floors (≥ shown; pagination cap):
| Classification | Count (floor) |
|---|---|
| Pathogenic | 0 |
| Likely pathogenic | 0 |
| Uncertain significance | 53 |
| Likely benign | 8 |
| Benign | 1 |
Top pathogenic / likely-pathogenic (0)
SpliceAI
963 predictions. Top by Δscore:
| Variant | Effect | Δscore |
|---|---|---|
| 5:134968086:T:G | donor_gain | 1.0000 |
| 5:134968086:T:TG | donor_gain | 1.0000 |
| 5:134968090:G:GG | donor_gain | 1.0000 |
| 5:134996271:A:AG | acceptor_gain | 1.0000 |
| 5:134996272:G:GG | acceptor_gain | 1.0000 |
| 5:135008838:CAGG:C | acceptor_loss | 1.0000 |
| 5:135008839:AGGTT:A | acceptor_gain | 1.0000 |
| 5:135008840:GGTTG:G | acceptor_gain | 1.0000 |
| 5:135008978:AGAG:A | donor_loss | 1.0000 |
| 5:135008979:GAG:G | donor_gain | 1.0000 |
| 5:135008980:AGG:A | donor_loss | 1.0000 |
| 5:135008981:GGTGA:G | donor_loss | 1.0000 |
| 5:135008982:G:T | donor_loss | 1.0000 |
| 5:135008983:T:A | donor_loss | 1.0000 |
| 5:135009366:TCTA:T | acceptor_loss | 1.0000 |
| 5:135009367:CTAG:C | acceptor_loss | 1.0000 |
| 5:135009369:A:AG | acceptor_gain | 1.0000 |
| 5:135009369:AG:A | acceptor_gain | 1.0000 |
| 5:135009370:G:GA | acceptor_gain | 1.0000 |
| 5:135009370:GG:G | acceptor_gain | 1.0000 |
| 5:135009370:GGA:G | acceptor_gain | 1.0000 |
| 5:135009370:GGAC:G | acceptor_gain | 1.0000 |
| 5:135009370:GGACT:G | acceptor_gain | 1.0000 |
| 5:135009486:TACAG:T | donor_gain | 1.0000 |
| 5:135009490:GGTG:G | donor_loss | 1.0000 |
| 5:135009491:G:GA | donor_loss | 1.0000 |
| 5:135009491:G:GG | donor_gain | 1.0000 |
| 5:135009492:T:A | donor_loss | 1.0000 |
| 5:135010367:CTCTA:C | acceptor_loss | 1.0000 |
| 5:135010369:CTAGA:C | acceptor_loss | 1.0000 |
AlphaMissense
2681 scored. Top likely-pathogenic:
| Variant | Protein change | am_pathogenicity |
|---|---|---|
| 5:135008094:G:C | W210C | 0.982 |
| 5:135008094:G:T | W210C | 0.982 |
| 5:135008850:T:A | W229R | 0.977 |
| 5:135008850:T:C | W229R | 0.977 |
| 5:135008092:T:A | W210R | 0.974 |
| 5:135008092:T:C | W210R | 0.974 |
| 5:135008059:T:C | F199L | 0.969 |
| 5:135008061:T:A | F199L | 0.969 |
| 5:135008061:T:G | F199L | 0.969 |
| 5:135008852:G:C | W229C | 0.967 |
| 5:135008852:G:T | W229C | 0.967 |
| 5:135008916:T:C | F251L | 0.967 |
| 5:135008918:C:A | F251L | 0.967 |
| 5:135008918:C:G | F251L | 0.967 |
| 5:135008125:T:C | F221L | 0.957 |
| 5:135008127:C:A | F221L | 0.957 |
| 5:135008127:C:G | F221L | 0.957 |
| 5:135008035:T:C | F191L | 0.956 |
| 5:135008037:C:A | F191L | 0.956 |
| 5:135008037:C:G | F191L | 0.956 |
| 5:135008895:A:C | S244R | 0.953 |
| 5:135008897:C:A | S244R | 0.953 |
| 5:135008897:C:G | S244R | 0.953 |
| 5:135008934:T:C | F257L | 0.952 |
| 5:135008936:C:A | F257L | 0.952 |
| 5:135008936:C:G | F257L | 0.952 |
| 5:135008047:G:C | G195R | 0.951 |
| 5:135008050:T:C | F196L | 0.948 |
| 5:135008052:C:A | F196L | 0.948 |
| 5:135008052:C:G | F196L | 0.948 |
dbSNP variants (sampled 300 via entrez): RS1000004533 (5:134997016 G>A), RS1000114835 (5:135007710 A>G), RS1000217408 (5:135011678 T>C), RS1000300586 (5:134987441 T>A), RS1000327603 (5:134970562 T>C), RS1000410622 (5:134967004 T>C), RS1000449905 (5:135006661 T>C), RS1000584158 (5:134985594 A>G), RS1000584968 (5:134993148 G>A), RS1000603863 (5:134998136 T>A), RS1000755325 (5:135006488 T>C), RS1000963952 (5:134980853 A>T), RS1000975385 (5:134968836 A>G), RS1001060708 (5:134981026 C>T), RS1001143629 (5:134985936 C>A)
Disease associations
OMIM: gene MIM:609120 | disease phenotypes:
GenCC curated gene-disease
Mondo (0):
Orphanet (0):
HPO phenotypes
0 total (0 of 0 shown, HPO-id order):
GWAS associations
12 associations (top):
| Study | Trait | p-value |
|---|---|---|
| GCST000175_35 | Height | 8.000000e-06 |
| GCST001792_5 | Colorectal cancer | 4.000000e-10 |
| GCST001792_7 | Colorectal cancer | 1.000000e-10 |
| GCST001958_2 | Bulimia nervosa | 3.000000e-06 |
| GCST002022_4 | Testicular germ cell tumor | 2.000000e-08 |
| GCST002702_118 | Height | 9.000000e-09 |
| GCST004713_21 | Testicular germ cell tumor | 9.000000e-06 |
| GCST006979_122 | Heel bone mineral density | 1.000000e-16 |
| GCST008156_139 | Hip circumference adjusted for BMI | 8.000000e-06 |
| GCST008163_526 | Height | 9.000000e-11 |
| GCST008839_492 | Height | 8.000000e-18 |
| GCST90020028_993 | Hip circumference adjusted for BMI | 2.000000e-08 |
EFO canonical traits (2, from GWAS)
| EFO ID | Trait name |
|---|---|
| EFO:0009270 | heel bone mineral density |
| EFO:0008039 | BMI-adjusted hip circumference |
Drugs & pharmacology
Drug and pharmacology data
Is drug target: no
PharmGKB: 1 entry (VIP=true, CPIC=false)
GtoPdb / IUPHAR curated pharmacology
(IUPHAR/BPS Guide to Pharmacology — expert-curated)
Target class: vgic — CatSper and Two-Pore channels (TPC)
Most potent curated ligand interactions (9 total), top 9:
| Ligand | Action | Affinity | Parameter |
|---|---|---|---|
| progesterone | Full agonist | 8.11 | pEC50 |
| PGE1 | Full agonist | 6.3 | pEC50 |
| PGE2 | Full agonist | 6.3 | pEC50 |
| PGF1α | Full agonist | 6.3 | pEC50 |
| NNC55-0396 | Inhibition | 5.7 | pIC50 |
| ruthenium red | Antagonist | 5.0 | pIC50 |
| mibefradil | Inhibition | 4.5 | pIC50 |
| Cd2+ | Antagonist | 3.7 | pIC50 |
| Ni2+ | Antagonist | 3.5 | pIC50 |
CTD chemical–gene interactions
7 total (human), top 7 by PubMed support.
| Chemical | Actions (top 5) | PubMed papers |
|---|---|---|
| Tobacco Smoke Pollution | decreases expression, increases expression | 2 |
| methyleugenol | decreases expression | 1 |
| tris(1,3-dichloro-2-propyl)phosphate | increases expression | 1 |
| sodium arsenite | decreases expression | 1 |
| CGP 52608 | affects binding, increases reaction | 1 |
| Sunitinib | decreases expression | 1 |
| Quercetin | increases expression | 1 |
Clinical trials (associated diseases)
0 trials via MONDO — disease-level, not drug-specific.
Related Atlas pages
- Targeted by drugs: Alprostadil, Dinoprostone, Mibefradil, Progesterone
- Disease cohort memberships (association, not causation — diseases whose associated-gene cohort lists this gene; a subset are also under Associated diseases): bulimia nervosa, testicular cancer, testicular germ cell tumor