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Lu B, Shi H. An In-Depth Look at Small Cell Carcinoma of the Ovary, Hypercalcemic Type (SCCOHT): Clinical Implications from Recent Molecular Findings. J Cancer 2019; 10:223-237. [PMID: 30662543 PMCID: PMC6329856 DOI: 10.7150/jca.26978] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 10/21/2018] [Indexed: 12/27/2022] Open
Abstract
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a highly aggressive cancer in young women. The histogenesis remains unclear although a potential origin of germ cells has been suggested recently. The high throughput next generation sequencing techniques have facilitated the identification of inactivating SMARCA4 mutations as the driver of SCCOHT. These findings may greatly impact on the prevention, diagnosis, molecular classification and treatment of SCCOHTs. The SMARCA4 mutations, typically associated with dual loss of BRG1 and BRM expression, are highly sensitive and specific for the diagnosis of SCCOHT. Germline mutations of SMARCA4 support familial SCCOHT with a critical requirement of genetic counseling and possible prophylactic surgery for carriers. SCCOHT, malignant atypical teratoid/rhabdoid tumors, thoracic sarcomas and some undifferentiated carcinomas harbor rhabdoid morphology and mutations in the SMARC genes, generating an emerging molecular classification of SMARC-mutated tumors. A multi-modality treatment approach consisting of surgery and high dose multi-agent chemotherapy in atypical teratoid/rhabdoid tumors may have potential benefits for SCCOHT patients. Preliminary studies have implicated that the inhibitors targeting EZH2 and the receptor tyrosine kinase, and anti-PD-L1 immunotherapy might be potentially effective for SCCOHT patients. These recent advances on molecular genetics, diagnosis and treatment of SCCOHT address the necessity of multiple institutional collaboration work among oncologist, pathologist, genomic scientist, geneticist, molecular biologist, and pharmacologist.
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Affiliation(s)
- Bingjian Lu
- Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China.,Center for Uterine Cancer Diagnosis & Therapy Research of Zhejiang Province, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
| | - Haiyan Shi
- Department of Surgical Pathology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China
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Detection of the DICER1 hotspot mutation alongside immunohistochemical analysis may provide a better diagnostic measure for ovarian Sertoli-Leydig cell tumors. Pathol Res Pract 2018; 214:1370-1375. [DOI: 10.1016/j.prp.2018.02.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/30/2018] [Accepted: 02/18/2018] [Indexed: 12/15/2022]
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A rare malignant thyroid carcinosarcoma with aggressive behavior and DICER1 gene mutation: a case report with literature review. Thyroid Res 2018; 11:11. [PMID: 30083234 PMCID: PMC6069891 DOI: 10.1186/s13044-018-0055-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 07/16/2018] [Indexed: 12/17/2022] Open
Abstract
Background Malignant biphasic tumor also known as carcinosarcoma is an uncommon neoplasm that is composed of both malignant epithelial and mesenchymal components. Most reported cases of carcinosarcoma affect the female genital tract; however, other sites including head and neck, lung, and breast have been described. Carcinosarcoma of the thyroid is an extremely rare and aggressive malignancy with an ominous clinical course similar to anaplastic carcinoma. Case presentation We report a case of a 45-year-old female who was found to have a biphasic thyroid carcinosarcoma. Her clinical course declined significantly shortly after she underwent a total thyroidectomy and she developed distant metastases to the lungs. Histopathological features of the primary and metastatic tumor were identical. The tumor is composed of an intimately intermixed epithelial component of poorly differentiated follicular thyroid carcinoma and a spindle cell sarcoma with rhabdomyosarcoma differentiation. Molecular analysis using a next-generation sequencing based assay revealed a DICER1 (E1705K) point mutation in neoplastic cells. Conclusion To our knowledge, the E1705K point mutation within the DICER1 gene is the first reported mutation in carcinosarcoma of the thyroid. A comprehensive review of the relevant literature is also included for discussion.
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Jang NR, Lee DH, Jang EJ, Bae YK, Baek J, Jang MH. Ovarian Gynandroblastoma with a Juvenile Granulosa Cell Tumor Component in a Postmenopausal Woman: A Case Report and Literature Review. J Pathol Transl Med 2018; 52:344-348. [PMID: 30011982 PMCID: PMC6166011 DOI: 10.4132/jptm.2018.06.28] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/28/2018] [Indexed: 11/17/2022] Open
Abstract
Gynandroblastoma is an extremely rare sex cord-stromal tumor with both female (granulosa cell tumor) and male (Sertoli-Leydig cell tumor) elements. Juvenile granulosa cell tumors are also very rare and are so named because they usually occur in children and adolescents. A 71-year-old woman with right upper quadrant abdominal pain visited our hospital. Pelvic computed tomography showed a large multilocular cystic mass, suspected to be of ovarian origin. We performed a total abdominal hysterectomy (total abdominal hysterectomy was performed) with bilateral salpingo-oophorectomy. A 13-cm multilocular cystic mass with serous fluid was observed in her right ovary. Upon microscopic examination, the solid component of the mass showed both Sertoli-Leydig cell and juvenile granulosa cell differentiation, which we diagnosed as gynandroblastoma. Gynandroblastoma with a juvenile granulosa cell tumor component is extremely rare and, until now, only six cases have been reported in the English literature. We report the first gynandroblastoma with a juvenile granulosa cell tumor component diagnosed in an elderly patient, along with a literature review.
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Affiliation(s)
- Nu Ri Jang
- Department of Pathology, Yeungnam University School of Medicine, Daegu, Korea
| | - Dae Hyung Lee
- Department of Gynecology and Obstetrics, Yeungnam University School of Medicine, Daegu, Korea
| | - Eun Jung Jang
- Department of Pathology, Fatima Hospital, Daegu, Korea
| | - Young Kyung Bae
- Department of Pathology, Yeungnam University School of Medicine, Daegu, Korea
| | - Jina Baek
- Department of Pathology, Yeungnam University School of Medicine, Daegu, Korea
| | - Min Hye Jang
- Department of Pathology, Yeungnam University School of Medicine, Daegu, Korea
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56
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Lopes CB, Magalhães LL, Teófilo CR, Alves APNN, Montenegro RC, Negrini M, Ribeiro-dos-Santos Â. Differential expression of hsa-miR-221, hsa-miR-21, hsa-miR-135b, and hsa-miR-29c suggests a field effect in oral cancer. BMC Cancer 2018; 18:721. [PMID: 29976158 PMCID: PMC6034275 DOI: 10.1186/s12885-018-4631-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 06/25/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The theory of field effect suggests that the tumor-adjacent area, besides histopathologically normal, undergoes genetic and epigenetic changes that can eventually affect epithelial homeostasis, predisposing the patient to cancer development. One of the many molecular changes described in cancer are microRNAs (miRNAs), which regulates the expression of important genes during carcinogenesis. Thus, the aim of this study was to investigate the field effect in oral cancer. METHODS We investigated the differential expression profile of four miRNAs (hsa-miR-221, hsa-miR-21, hsa-miR-135b, and hsa-miR-29c) in cancerous oral tissue, in tumor-adjacent tissue and and in non-cancerous tissue samples from healthy volunteers. RESULTS Our results showed significant overexpression profiles of all four studied miRNAs in cancerous oral tissue compared to non-cancerous samples, as well as in tumor-adjacent tissue compared to cancer-free tissue. No significant difference was found when comparing the expression profile of cancerous and tissue-adjacent tissue groups. We found a negative correlation between the expression of hsa-miR-21 expression and STAT3 in oral squamous cell carcinoma. CONCLUSION These results suggest that the tissue adjacent to cancer cannot be considered a normal tissue because its molecular aspects are significantly altered. Our data corroborates the hypothesis of field cancerization.
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Affiliation(s)
- Camile B. Lopes
- Laboratory of Human and Medical Genetics, Graduate Program of Genetics and Molecular Biology, Federal University of Pará, Belém, PA 66075-110 Brazil
| | - Leandro L. Magalhães
- Laboratory of Human and Medical Genetics, Graduate Program of Genetics and Molecular Biology, Federal University of Pará, Belém, PA 66075-110 Brazil
| | - Carolina R. Teófilo
- Department of Clinical Dentistry - Health Sciences Center, Federal University of Ceará, Fortaleza, CE 60020-181 Brazil
| | - Ana Paula N. N. Alves
- Department of Clinical Dentistry - Health Sciences Center, Federal University of Ceará, Fortaleza, CE 60020-181 Brazil
| | - Raquel C. Montenegro
- Center of Research and Drug Development, Federal University of Ceara, Fortaleza, CE 60430-270 Brazil
| | - Massimo Negrini
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, 44121 Ferrara, Italy
| | - Ândrea Ribeiro-dos-Santos
- Laboratory of Human and Medical Genetics, Graduate Program of Genetics and Molecular Biology, Federal University of Pará, Belém, PA 66075-110 Brazil
- Research Center of Oncology, Federal University of Pará, 66, Belém, PA 073-005 Brazil
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57
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Wang Y, Karnezis AN, Magrill J, Tessier-Cloutier B, Lum A, Senz J, Gilks CB, McCluggage WG, Huntsman DG, Kommoss F. DICER1 hot-spot mutations in ovarian gynandroblastoma. Histopathology 2018; 73:306-313. [PMID: 29660837 DOI: 10.1111/his.13630] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/08/2018] [Indexed: 12/20/2022]
Abstract
AIMS Gynandroblastoma is a rare ovarian sex cord-stromal tumour characterised by the presence of both male (Sertoli and/or Leydig cells) and female (granulosa cells) components. We investigated the mutational status of DICER1, FOXL2 and AKT1 genes at hot-spot regions that are known to be the key driving events in the development of Sertoli-Leydig cell tumour (SLCT), adult granulosa cell tumour (aGCT) and juvenile granulosa cell tumour (jGCT), respectively, to gain insights into the molecular pathogenesis of gynandroblastoma. METHODS AND RESULTS Sixteen cases of gynandroblastoma were studied. All contained SLCT or Sertoli cell tumour components. aGCT and jGCT components were identified in seven and 10 cases, respectively, with one presenting both components. Heterozygous hot-spot mutations in the RNase IIIb domain of DICER1 were discovered in three cases, including one case with heterologous mucinous elements, all of which were composed of moderately or poorly differentiated SLCT and jGCT components, and harboured the mutations in both histological components. None of the 16 cases displayed mutations at the p.C134W (c.402C→G) of FOXL2 or within the pleckstrin-homology domain of AKT1. All cases showed FOXL2 immunostaining in both male and female components. CONCLUSION DICER1 hot-spot mutation is the key-driving event in a subset of gynandroblastomas containing components of SLCT and jGCT. Gynandroblastomas composed of SLCT and jGCT may represent morphological variants of SLCT. The molecular basis of gynandroblastoma containing a component of aGCT is different from pure aGCT.
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Affiliation(s)
- Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Jamie Magrill
- Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Basile Tessier-Cloutier
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada.,Molecular Oncologic Pathology Fellowship Program, Terry Fox Research Institute, Vancouver, BC, Canada
| | - Amy Lum
- Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Janine Senz
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, Northern Ireland, UK
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, British Columbia Cancer Research Centre, Vancouver, BC, Canada.,Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver, BC, Canada
| | - Friedrich Kommoss
- Institute of Pathology, Medizin Campus Bodensee, Friedrichshafen, Germany
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Robertson JC, Jorcyk CL, Oxford JT. DICER1 Syndrome: DICER1 Mutations in Rare Cancers. Cancers (Basel) 2018; 10:cancers10050143. [PMID: 29762508 PMCID: PMC5977116 DOI: 10.3390/cancers10050143] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/13/2018] [Accepted: 05/14/2018] [Indexed: 12/20/2022] Open
Abstract
DICER1 syndrome is a rare genetic disorder that predisposes individuals to multiple cancer types. Through mutations of the gene encoding the endoribonuclease, Dicer, DICER1 syndrome disrupts the biogenesis and processing of miRNAs with subsequent disruption in control of gene expression. Since the first description of DICER1 syndrome, case reports have documented novel germline mutations of the DICER1 gene in patients with cancers as well as second site mutations that alter the function of the Dicer protein expressed. Here, we present a review of mutations in the DICER1 gene, the respective protein sequence changes, and clinical manifestations of DICER1 syndrome. Directions for future research are discussed.
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Affiliation(s)
- Jake C Robertson
- Department of Biological Sciences, Boise State University, Boise, ID 83725-1515, USA.
| | - Cheryl L Jorcyk
- Department of Biological Sciences, Boise State University, Boise, ID 83725-1515, USA.
- Biomolecular Research Center, Boise State University, Boise, ID 83725-1511, USA.
| | - Julia Thom Oxford
- Department of Biological Sciences, Boise State University, Boise, ID 83725-1515, USA.
- Biomolecular Research Center, Boise State University, Boise, ID 83725-1511, USA.
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59
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Garg K, Karnezis AN, Rabban JT. Uncommon hereditary gynaecological tumour syndromes: pathological features in tumours that may predict risk for a germline mutation. Pathology 2018; 50:238-256. [PMID: 29373116 DOI: 10.1016/j.pathol.2017.10.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 10/24/2017] [Accepted: 10/25/2017] [Indexed: 12/31/2022]
Abstract
The most common hereditary gynaecological tumour syndromes are hereditary breast and ovarian cancer syndrome and Lynch syndrome. However, pathologists also may encounter gynaecological tumours in women with rare hereditary syndromes. Many of these tumours exhibit distinctive gross and microscopic features that are associated with a risk for an inherited gene mutation. The sensitivity and specificity of these tumour pathology features for predicting an inherited mutation vary depending on the syndrome. By recognising these tumour features, pathologists may potentially contribute to the diagnosis of an unsuspected syndrome by recommending referral of the patient for formal risk assessment by genetic counselling. Patients additionally benefit from diagnosis of an inherited syndrome because many also carry a lifetime risk for developing primary malignancies outside of the gynaecological tract. Early diagnosis of an inherited syndrome permits early screening, detection, and management of additional malignancies associated with the syndrome. This review highlights these rare syndromes and their tumour pathology, including Peutz-Jeghers syndrome (gastric type mucinous carcinoma of the cervix; ovarian sex cord tumour with annular tubules); hereditary leiomyoma renal cell carcinoma syndrome (uterine leiomyoma); tuberous sclerosis complex (uterine PEComa; uterine lymphangioleiomyomatosis); DICER1 syndrome (ovarian Sertoli-Leydig cell tumour; cervical embryonal rhabdomyosarcoma); rhabdoid tumour predisposition syndrome 2 (small cell carcinoma of the ovary, hypercalcaemic type); Cowden syndrome (endometrial endometrioid adenocarcinoma); naevoid basal cell carcinoma syndrome (ovarian fibroma); and Von Hippel-Lindau syndrome (clear cell papillary cystadenoma of the broad ligament).
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Affiliation(s)
- Karuna Garg
- University of California San Francisco, Pathology Department, San Francisco, CA, United States
| | - Anthony N Karnezis
- University of British Columbia, Department of Pathology and Laboratory Medicine, Vancouver, Canada
| | - Joseph T Rabban
- University of California San Francisco, Pathology Department, San Francisco, CA, United States.
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Lim D, Oliva E. Ovarian sex cord-stromal tumours: an update in recent molecular advances. Pathology 2017; 50:178-189. [PMID: 29275930 DOI: 10.1016/j.pathol.2017.10.008] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 10/17/2017] [Indexed: 01/17/2023]
Abstract
Sex cord-stromal tumours (SCSTs) consist of a heterogeneous group of neoplasms with diverse clinicopathological features and biological behaviour. They often present as a diagnostic challenge as they have varied and occasionally overlapping histomorphology and some may even mimic non-SCSTs. An accurate diagnosis is important for therapeutic and prognostic purposes. The use of a panel of immunohistochemical markers which are sensitive and specific for sex cord-stromal differentiation such as α-inhibin, calretinin, SF-1 and FOXL2, may be helpful in confirming the cellular lineage of these tumours, but is of limited utility in distinguishing between the different tumour types within this category. Additionally, the development of new therapeutic strategies in patients with SCSTs is also hampered by the infrequent occurrence of these neoplasms. Recent molecular analyses of some SCSTs has led to the discovery of novel molecular events, which may have important diagnostic, prognostic and therapeutic implications. The salient pathological features, management issues and recently described genetic aberrations in adult and juvenile granulosa cell tumours as well as Sertoli-Leydig cell tumours are discussed in this review, with particular emphasis on the clinical significance of FOXL2 and DICER1 mutations. An in-depth understanding of the molecular pathogenesis underlying SCSTs may aid in improving tumour classification and disease prognostication and also potentially lead to the discovery of more effective treatment strategies.
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Affiliation(s)
- Diana Lim
- Department of Pathology, National University Hospital, Singapore; Translational Centre for Development and Research, National University Health System, Singapore.
| | - Esther Oliva
- Department of Pathology, Massachusetts General Hospital, Boston, MA, United States
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61
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Howitt BE, Nucci MR. Mesonephric proliferations of the female genital tract. Pathology 2017; 50:141-150. [PMID: 29269124 DOI: 10.1016/j.pathol.2017.11.084] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 11/02/2017] [Indexed: 01/05/2023]
Abstract
The mesonephric (Wolffian) duct regresses in females during embryological development. Remnants of this duct may persist typically along the lateral walls of the cervix, vagina, adnexa, and uterine corpus. These mesonephric epithelia may expand into hyperplastic proliferations and rarely form neoplasms. The spectrum of morphology, immunophenotype, clinical presentation, and molecular characteristics of mesonephric lesions is reviewed, with attention to distinction from entities in the differential diagnosis.
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Affiliation(s)
- Brooke E Howitt
- Brigham and Women's Hospital, Department of Pathology, Division of Women's and Perinatal Pathology, Boston, MA, USA; Department of Pathology, Stanford School of Medicine, Stanford, CA, United States.
| | - Marisa R Nucci
- Brigham and Women's Hospital, Department of Pathology, Division of Women's and Perinatal Pathology, Boston, MA, USA.
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Schultz KAP, Harris AK, Schneider DT, Young RH, Brown J, Gershenson DM, Dehner LP, Hill DA, Messinger YH, Frazier AL. Ovarian Sex Cord-Stromal Tumors. J Oncol Pract 2017; 12:940-946. [PMID: 27858560 DOI: 10.1200/jop.2016.016261] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Ovarian sex cord-stromal tumors are clinically significant heterogeneous tumors that include several pathologic types. These tumors are often found in adolescents and young adults and can present with hormonal manifestations as well as signs and symptoms of a pelvic mass. Serum tumor markers may assist in preoperative diagnosis and surveillance. Several subtypes are associated with genetic predisposition, including those observed in patients with Peutz-Jegher syndrome. Recent studies have elucidated the relationship between Sertoli-Leydig cell tumors and DICER1 mutations. When classified as International Federation of Gynecology and Obstetrics stage Ia, most subtypes may be treated with surgery alone. Higher stage or recurrent tumors have variable prognoses that range from a usually rapid course in poorly differentiated Sertoli-Leydig cell tumor to an often prolonged course in adult granulosa cell tumors. New understanding of the molecular pathogenesis of these tumors may pave the way for novel therapeutics.
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Affiliation(s)
- Kris Ann P Schultz
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Anne K Harris
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Dominik T Schneider
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Robert H Young
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Jubilee Brown
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - David M Gershenson
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Louis P Dehner
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - D Ashley Hill
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - Yoav H Messinger
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
| | - A Lindsay Frazier
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN; Massachusetts General Hospital, Harvard Medical School; Dana-Farber Cancer Center/Children's Cancer Care, Boston, MA; Levine Cancer Institute, Carolinas Medical Center, Charlotte, NC; The University of Texas MD Anderson Cancer Center, Houston, TX; Washington University Medical Center, St Louis, MO; Children's National Medical Center and Center for Genetic Medicine Research, Children's Research Institute, Washington, DC; and Clinic of Pediatrics, Dortmund, Germany
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64
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DICER1 Mutations Are Consistently Present in Moderately and Poorly Differentiated Sertoli-Leydig Cell Tumors. Am J Surg Pathol 2017; 41:1178-1187. [DOI: 10.1097/pas.0000000000000895] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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65
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Bueno MT, Martínez-Ríos C, la Puente Gregorio AD, Ahyad RA, Villani A, Druker H, van Engelen K, Gallinger B, Aronoff L, Grant R, Malkin D, Greer MLC. Pediatric imaging in DICER1 syndrome. Pediatr Radiol 2017; 47:1292-1301. [PMID: 28474256 DOI: 10.1007/s00247-017-3875-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 02/26/2017] [Accepted: 04/20/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND DICER1 syndrome, arising from a mutation in the DICER1 gene mapped to chromosome 14q32, is associated with an increased risk of a range of benign and malignant neoplasms. OBJECTIVE To determine the spectrum of abnormalities and imaging characteristics in patients with DICER1 syndrome at a tertiary pediatric hospital. MATERIALS AND METHODS This retrospective analysis evaluated imaging in patients ≤18 years with DICER1 germline variants between January 2004 and July 2016. An imaging database search including keywords pleuropulmonary blastoma, cystic nephroma, pineoblastoma, embryonal rhabdomyosarcoma, ovarian sex cord-stromal tumor, ovarian Sertoli-Leydig cell tumor and DICER1 syndrome, was cross-referenced against the institutional Cancer Genetics Program database, excluding patients with negative/unknown DICER1 gene testing. RESULTS Sixteen patients were included (12 females; mean age at presentation: 4.2 years, range: 14 days to 17 years), with surveillance imaging encompassing the following modalities: chest X-ray and CT; abdominal, pelvic and neck US; and brain and whole-body MRI. Malignant lesions (68.8% of patients) included pleuropulmonary blastoma (5), pineoblastoma (3), ovarian Sertoli-Leydig cell tumor (1), embryonal rhabdomyosarcoma (1) and renal sarcoma (1); benign lesions (37.5% of patients) included thyroid cysts (2), thyroid nodules (2), cystic nephroma (2), renal cysts (1) and pineal cyst (1). A common lesional appearance observed across modalities and organs was defined as the "cracked windshield" sign. CONCLUSION The spectrum of DICER1-related tumors and the young age at presentation suggest early surveillance of at-risk patients is critical, while minimizing exposure to ionizing radiation.
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Affiliation(s)
- Marta Tijerin Bueno
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Claudia Martínez-Ríos
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | | | - Rayan A Ahyad
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Anita Villani
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Harriet Druker
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Kalene van Engelen
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bailey Gallinger
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Genetic Counselling, The Hospital for Sick Children, Toronto, Ontario, Canada
- Department of Molecular Genetics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Laura Aronoff
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald Grant
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - David Malkin
- Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
- Division of Hematology/Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
- Genetics & Genomic Biology Program, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mary-Louise C Greer
- Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Ave., Toronto, Ontario, M5G 1X8, Canada.
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada.
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66
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Abstract
The nucleolus is a distinct compartment of the nucleus responsible for ribosome biogenesis. Mis-regulation of nucleolar functions and of the cellular translation machinery has been associated with disease, in particular with many types of cancer. Indeed, many tumor suppressors (p53, Rb, PTEN, PICT1, BRCA1) and proto-oncogenes (MYC, NPM) play a direct role in the nucleolus, and interact with the RNA polymerase I transcription machinery and the nucleolar stress response. We have identified Dicer and the RNA interference pathway as having an essential role in the nucleolus of quiescent Schizosaccharomyces pombe cells, distinct from pericentromeric silencing, by controlling RNA polymerase I release. We propose that this novel function is evolutionarily conserved and may contribute to the tumorigenic pre-disposition of DICER1 mutations in mammals.
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Affiliation(s)
- Benjamin Roche
- a Martienssen Lab, Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA
| | - Benoît Arcangioli
- b Genome Dynamics Unit, UMR 3525 CNRS, Institut Pasteur , Paris , France
| | - Rob Martienssen
- a Martienssen Lab, Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA.,c Howard Hughes Medical Institute, Cold Spring Harbor Laboratory , Cold Spring Harbor , NY , USA
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67
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MicroRNAs in Sertoli cells: implications for spermatogenesis and fertility. Cell Tissue Res 2017; 370:335-346. [DOI: 10.1007/s00441-017-2667-z] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Accepted: 06/30/2017] [Indexed: 12/12/2022]
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68
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Sertoli-Leydig Cell Tumor with Concurrent Rhabdomyosarcoma: Three Case Reports and a Review of the Literature. Case Rep Med 2017; 2017:4587296. [PMID: 28751916 PMCID: PMC5511678 DOI: 10.1155/2017/4587296] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 05/19/2017] [Accepted: 05/29/2017] [Indexed: 12/24/2022] Open
Abstract
Sertoli-Leydig Cell Tumors (SLCTs) make up <1% of all ovarian tumors and are benign or malignant, androgen-secreting tumors. Rhabdomyosarcoma (RMS) is a heterogeneous group of malignant tumors that resemble developing skeletal muscle. There have been case reports of patients with concurrent SLCT and RMS with limited treatment options. We aim to demonstrate treatment strategies used in our patients, which seemed to have prolonged survival when compared to prior case reports of patients not cured by surgical resection. Herein we describe 22 cases of SLCT with RMS elements as discussed in prior case reports and three cases from the authors' institution. Of the 19 cases from prior case reports, five were lost to follow-up and two had NED after surgical intervention. Eleven patients had recurrence and were deceased within one year. Of those patients not surgically cured, only three patients were documented as living beyond two years, all of whom received chemotherapy. The three patients presented from our institution had clinical evidence of response to chemotherapy that is traditionally used for RMS. In conclusion, chemotherapy with doxorubicin and ifosfamide has activity in patients with SLCT and RMS as does salvage chemotherapy with vincristine, irinotecan, and temozolomide.
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69
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Roth LM, Lyu B, Cheng L. Perspectives on testicular sex cord–stromal tumors and those composed of both germ cells and sex cord–stromal derivatives with a comparison to corresponding ovarian neoplasms. Hum Pathol 2017; 65:1-14. [DOI: 10.1016/j.humpath.2017.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 04/05/2017] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
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70
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Childhood tumours with a high probability of being part of a tumour predisposition syndrome; reason for referral for genetic consultation. Eur J Cancer 2017; 80:48-54. [DOI: 10.1016/j.ejca.2017.04.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 04/10/2017] [Accepted: 04/20/2017] [Indexed: 12/11/2022]
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71
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de Kock L, Rivera B, Revil T, Thorner P, Goudie C, Bouron-Dal Soglio D, Choong CS, Priest JR, van Diest PJ, Tanboon J, Wagner A, Ragoussis J, Choong PFM, Foulkes WD. Sequencing of DICER1 in sarcomas identifies biallelic somatic DICER1 mutations in an adult-onset embryonal rhabdomyosarcoma. Br J Cancer 2017; 116:1621-1626. [PMID: 28524158 PMCID: PMC5518865 DOI: 10.1038/bjc.2017.147] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 04/25/2017] [Accepted: 04/26/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Sarcomas are rare and heterogeneous cancers. We assessed the contribution of DICER1 mutations to sarcoma development. METHODS The coding region of DICER1 was sequenced in 67 sarcomas using a custom Fluidigm Access Array. The RNase III domains were Sanger sequenced in six additional sarcomas to identify hotspot DICER1 variants. RESULTS The median age of sarcoma diagnosis was 45.7 years (range: 3 months to 87.4 years). A recurrent embryonal rhabdomyosarcoma (ERMS) of the broad ligament, first diagnosed at age 23 years, harboured biallelic pathogenic somatic DICER1 variants (1 truncating and 1 RNase IIIb missense). We identified nine other DICER1 variants. One somatic variant (p.L1070V) identified in a pleomorphic sarcoma and one germline variant (c.2257-7A>G) may be pathogenic, but the others are considered to be benign. CONCLUSIONS We show that deleterious DICER1 mutations underlie the genetic basis of only a small fraction of sarcomas, in particular ERMS of the urogenital tract.
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Affiliation(s)
- Leanne de Kock
- Department of Human Genetics, McGill University, 1205 Dr. Penfield Avenue, Stewart Biology Building, Room N5/13, Montréal, QC H3A 1B1, Canada
- Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, 3755 Cote Sainte Catherine Road, Montréal, QC H3T 1E2, Canada
| | - Barbara Rivera
- Department of Human Genetics, McGill University, 1205 Dr. Penfield Avenue, Stewart Biology Building, Room N5/13, Montréal, QC H3A 1B1, Canada
- Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, 3755 Cote Sainte Catherine Road, Montréal, QC H3T 1E2, Canada
| | - Timothée Revil
- McGill University and Genome Quebec Innovation Centre, 740 Dr Penfield Avenue, Montréal, QC H3A 0G4, Canada
| | - Paul Thorner
- Division of Pathology, Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Catherine Goudie
- Department of Paediatrics, McGill University, 1001 Décarie Boulevard, Montréal, QC H4A 3J1, Canada
| | | | - Catherine S Choong
- Princess Margaret Hospital for Children, Roberts Road, Subiaco, WA 6008, Australia
- The University of Western Australia, 35 Stirling Highway, Perth, WA 6009, Australia
| | | | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Heidelberglaan 100, Utrecht 3584 CX, The Netherlands
| | - Jantima Tanboon
- Department of Pathology, Siriraj Hospital, Bangkok Noi, Bangkok 10700, Thailand
- Faculty of Medicine, Mahidol University, Bangkok Noi, Bangkok 10700, Thailand
| | - Anja Wagner
- Department of Clinical Genetics, Erasmus MC University Medical Center, Wytemaweg 80, Rotterdam 3015 CN, The Netherlands
| | - Jiannis Ragoussis
- McGill University and Genome Quebec Innovation Centre, 740 Dr Penfield Avenue, Montréal, QC H3A 0G4, Canada
| | - Peter FM Choong
- Department of Surgery, St. Vincent’s Hospital Melbourne, University of Melbourne, 41 Victoria Parade, Melbourne, VIC 3065, Australia
| | - William D Foulkes
- Department of Human Genetics, McGill University, 1205 Dr. Penfield Avenue, Stewart Biology Building, Room N5/13, Montréal, QC H3A 1B1, Canada
- Lady Davis Institute, Segal Cancer Centre, Jewish General Hospital, 3755 Cote Sainte Catherine Road, Montréal, QC H3T 1E2, Canada
- Department of Medical Genetics, Research Institute of the McGill University Health Centre, 1001 Décarie Boulevard, Montréal, QC H4A 3J1, Canada
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72
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Wang XJ, Jiang FZ, Tong H, Ke JQ, Li YR, Zhang HL, Yan XF, Wang FY, Wan XP. Dicer1 dysfunction promotes stemness and aggression in endometrial carcinoma. Tumour Biol 2017; 39:1010428317695967. [PMID: 28381177 DOI: 10.1177/1010428317695967] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Endometrial carcinoma is one of the most common gynecological malignancies, but the molecular events involved in the development and progression of endometrial carcinoma remain unclear. Dicer1 and cancer stem cells play important roles in cell motility and survival. This study investigated the role of the let-7 family and Dicer1 in the stemness of endometrial carcinoma cells. We profiled Dicer1 expression in clinical samples and explored its relationship with stem cell-associated markers and clinical parameters. We showed that Dicer1 dysfunction leads to the enrichment of tumor stemness features and tumor aggression both in vitro and in vivo. We also identified the mechanism related to this potential tumor-predisposing phenotype: loss of Dicer1 induced abnormal expression of the let-7 family, which comprises well-known tumor suppressors, thus regulating stemness in endometrial carcinoma cells.
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Affiliation(s)
- Xiao-Jun Wang
- 1 Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, Shanghai, China
- 2 Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fei-Zhou Jiang
- 3 Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Huan Tong
- 1 Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jie-Qi Ke
- 2 Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi-Ran Li
- 1 Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hui-Lin Zhang
- 2 Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Fang Yan
- 2 Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Fang-Yuan Wang
- 2 Department of Obstetrics and Gynecology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao-Ping Wan
- 1 Department of Obstetrics and Gynecology, Shanghai First Maternity and Infant Health Hospital, Tongji University School of Medicine, Shanghai, China
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73
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Mullen MM, Divine LM, Hagemann IS, Babb S, Powell MA. Endometrial adenosarcoma in the setting of a germline DICER1 mutation: A case report. Gynecol Oncol Rep 2017; 20:121-124. [PMID: 28459098 PMCID: PMC5397585 DOI: 10.1016/j.gore.2017.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/05/2017] [Accepted: 04/08/2017] [Indexed: 12/04/2022] Open
Abstract
DICER1 mutations play a significant role in gynecologic malignancy. DICER1 may be involved in the sarcomagenesis of endometrial adenosarcoma. The knowledge of a genetic mutation can help clarify a patient's medical history.
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Affiliation(s)
- Mary M Mullen
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, USA
| | - Laura M Divine
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, USA
| | - Ian S Hagemann
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, USA.,Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Sheri Babb
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, USA
| | - Matthew A Powell
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, Alvin J. Siteman Cancer Center, St Louis, MO, USA
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74
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Germline and somatic DICER1 mutations in familial and sporadic liver tumors. J Hepatol 2017; 66:734-742. [PMID: 28012864 DOI: 10.1016/j.jhep.2016.12.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Revised: 11/04/2016] [Accepted: 12/09/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Growing evidence suggests that genetic predisposition significantly increases the risk of hepatocellular carcinoma (HCC), independently from the presence of other risk factors. Here, we report a novel germline DICER1 mutation associated with familial recurrent liver tumors. We then aimed to investigate the contribution of constitutional and somatic DICER1 mutations on HCC occurrence. METHODS We investigated two individuals of a single family that developed recurrent well-differentiated hepatocellular tumors over the years. Histological slides from surgically resected tumors were reviewed. Exome sequencing was performed on constitutional DNA from circulating lymphocytes in both patients. The presence of somatic DICER1 mutations was analyzed in 243 liver tumors. MicroRNA (miRNA) sequencing was performed in 50 liver tumors to identify groups of tumors with similar profiles and differentially expressed miRNAs (DEMs). RESULTS A pathological study identified hepatocellular adenomas and well-differentiated carcinomas in both patients. Tumors exhibited Wnt/β-catenin pathway activation, with strong and diffuse glutamine synthetase expression. Interestingly, non-tumor liver tissues showed abnormal liver zonation as previously reported in Dicer1 knockout mouse livers. Screening for DICER1 mutations in 243 sporadic liver tumors identified six tumors with somatic DICER1 mutations. In HCCs, DICER1 mutations were significantly associated with CTNNB1 mutations (p=0.03). miRNA profiling identified a specific expression profile in DICER1-mutated tumors with a decreased expression of mature miRNAs compared to the other samples. Among the DEMs, downregulation of let-7a and miR-365b was closely related to DICER1 mutations. CONCLUSIONS Our results highlight the role of DICER1 mutations in liver carcinogenesis in a specific subtype of familial and sporadic hepatocellular carcinomas associated with β-catenin activation. LAY SUMMARY DICER1 germline mutations are known to predispose individuals to the development of malignant tumors, mainly pleuropulmonary blastoma and ovarian Sertoli-Leydig cell tumor. Here, we described familial HCC associated with a novel DICER1 germline mutation and altered liver zonation. Familial and sporadic HCCs carrying DICER1 mutations are associated with CTNNB1 mutation and characterized by a reduced expression of specific mature miRNAs.
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75
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Fuller P, Leung D, Chu S. Genetics and genomics of ovarian sex cord-stromal tumors. Clin Genet 2017; 91:285-291. [DOI: 10.1111/cge.12917] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 10/22/2016] [Accepted: 10/24/2016] [Indexed: 12/20/2022]
Affiliation(s)
- P.J. Fuller
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Clayton Australia
- Department of Molecular and Translational Science; Monash University; Clayton Australia
| | - D. Leung
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Clayton Australia
- Department of Molecular and Translational Science; Monash University; Clayton Australia
| | - S. Chu
- Centre for Endocrinology and Metabolism; Hudson Institute of Medical Research; Clayton Australia
- Department of Molecular and Translational Science; Monash University; Clayton Australia
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76
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Kato N, Kusumi T, Kamataki A, Tsunoda R, Fukase M, Kurose A. DICER1 hotspot mutations in ovarian Sertoli-Leydig cell tumors: a potential association with androgenic effects. Hum Pathol 2017; 59:41-47. [DOI: 10.1016/j.humpath.2016.09.005] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 08/03/2016] [Accepted: 09/02/2016] [Indexed: 11/29/2022]
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77
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Karnezis AN, Cho KR, Gilks CB, Pearce CL, Huntsman DG. The disparate origins of ovarian cancers: pathogenesis and prevention strategies. Nat Rev Cancer 2017; 17:65-74. [PMID: 27885265 DOI: 10.1038/nrc.2016.113] [Citation(s) in RCA: 207] [Impact Index Per Article: 29.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Ovarian cancer is the fifth cause of cancer-related death in women and comprises a histologically and genetically broad range of tumours, including those of epithelial, sex cord-stromal and germ cell origin. Recent evidence indicates that high-grade serous ovarian carcinoma, clear cell carcinoma and endometrioid carcinoma primarily arise from tissues that are not normally present in the ovary. These histogenetic pathways are informing risk-reduction strategies for the prevention of ovarian and ovary-associated cancers and have highlighted the importance of the seemingly unique ovarian microenvironment.
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Affiliation(s)
- Anthony N Karnezis
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Kathleen R Cho
- Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan 48109, USA
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Celeste Leigh Pearce
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
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78
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Jarzembowski JA. Pediatric renal and genitourinary tract tumors and the contributions of Dr. Louis "Pepper" Dehner therewith. Semin Diagn Pathol 2016; 33:419-426. [PMID: 27720562 DOI: 10.1053/j.semdp.2016.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Dr. Louis "Pepper" Dehner is an internationally renowned surgical pathologist, especially in the subspecialty of pediatric pathology. Although his clinical and academic expertise are broad, with over 400 published articles, some of his most intriguing contributions have been in the area of pediatric renal and genitourinary pathology. This review focuses on the entities in these following organ systems where he has focused his efforts: malignant rhabdoid tumor, renal medullary carcinoma, Ewing sarcoma/peripheral neuroectodermal tumor, and the DICER1-related lesions cystic nephroma, embryonal rhabdomyosarcoma of the uterine cervix, and Sertoli-Leydig cell tumor.
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Affiliation(s)
- Jason A Jarzembowski
- Department of Pathology, Medical College of Wisconsin, Children׳s Hospital of Wisconsin, 9000 W. Wisconsin Ave, MS #701, Milwaukee, Wisconsin 53226.
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79
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Witkowski L, McCluggage WG, Foulkes WD. Recently characterized molecular events in uncommon gynaecological neoplasms and their clinical importance. Histopathology 2016; 69:903-913. [DOI: 10.1111/his.13058] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Leora Witkowski
- Department of Human Genetics; Lady Davis Institute and Segal Cancer Centre; Jewish General Hospital; McGill University; Montreal QC Canada
- Department of Medical Genetics; Lady Davis Institute and Segal Cancer Centre; Jewish General Hospital; McGill University; Montreal QC Canada
| | - W Glenn McCluggage
- Department of Pathology; Belfast Health and Social Care Trust; Belfast UK
| | - William D Foulkes
- Department of Human Genetics; Lady Davis Institute and Segal Cancer Centre; Jewish General Hospital; McGill University; Montreal QC Canada
- Department of Medical Genetics; Lady Davis Institute and Segal Cancer Centre; Jewish General Hospital; McGill University; Montreal QC Canada
- Department of Medical Genetics; Research Institute; McGill University Health Centre; Montreal QC Canada
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80
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Burnik Papler T, Frković Grazio S, Kobal B. Sertoli - Leydig cell tumor with retiform areas and overgrowth of rhabdomyosarcomatous elements: case report and literature review. J Ovarian Res 2016; 9:46. [PMID: 27473538 PMCID: PMC4967306 DOI: 10.1186/s13048-016-0257-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 07/22/2016] [Indexed: 01/29/2023] Open
Abstract
Background Sertoli - Leydig cell tumors (SLCTs) are sex-cord stromal tumors that account less than 0.5 % of primary ovarian neoplasms. They are mostly benign and occur in reproductive age women. Variants with heterologous mesenchymal elements are exceptionaly rare. The usual presentation of SLCTs is with signs of androgen excess as majority of them produce androgens. Case presentation We present a case of a SLCT occurring in a 70 year old woman. Her presenting complaint was abdominal distension and pain. She had no signs of androgen or estrogen excess. Transvaginal ultrasound (TVUS) and CT scan showed a multilocular adnexal tumor and level of CA 125 was raised. A complete cytoreduction was achieved with surgical procedure. Histopathological examination revealed moderately differentiated SLCT with retiform areas and owergrowth of heterologous component in form of embrional rhabdomyosarcoma (RMS). She returned 7 months after the surgery with a large abdominal mass, ascites, right- sided hydronephrosis and massive pulmonary embolism. Due to the widespread disease and her poor general condition, she received only palliative care. She died 15 days after the admission. No autopsy was performed. Conclusions Due to the rarity of SLCTs, especially those with retiform areas and heterologous elements, their management remains challenging. There is no firm evidence that adjuvant chemotherapy is effective in improving survival in SLCTs with malignant heterologous elements. Further studies with a higher number of cases and a longer follow-up are needed to better predicting the prognosis and determine the role of chemotherapy in such cases.
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Affiliation(s)
- T Burnik Papler
- Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 3, 1000, Ljubljana, Slovenia.,Department of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 3, 1000, Ljubljana, Slovenia
| | - S Frković Grazio
- Department of Gynecological Pathology, Division of Obstetrics and Gynecology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Department of Gynecological Pathology, University Medical Centre Ljubljana, Slajmerjeva 2, 1000, Ljubljana, Slovenia
| | - B Kobal
- Division of Obstetrics and Gynecology, University Medical Centre Ljubljana, Slajmerjeva 3, 1000, Ljubljana, Slovenia.
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81
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Abstract
Patients with germline DICER1 mutations are at increased risk of developing a wide range of tumors, most of which are relatively rare in the general population. In the gynecologic tract, these include ovarian sex cord-stromal tumors, particularly Sertoli-Leydig cell tumor, and embryonal rhabdomyosarcoma of the cervix. In some cases, these are the sentinel neoplasms. DICER1-associated tumors may have distinctive morphologic appearances that may prompt the pathologist to consider an underlying tumor predisposition syndrome and therefore consideration of genetic evaluation in the patient and her family.
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MESH Headings
- DEAD-box RNA Helicases/genetics
- Diagnosis, Differential
- Female
- Genetic Predisposition to Disease
- Genital Neoplasms, Female/diagnosis
- Genital Neoplasms, Female/genetics
- Genital Neoplasms, Female/pathology
- Germ-Line Mutation
- Humans
- Neoplastic Syndromes, Hereditary/diagnosis
- Neoplastic Syndromes, Hereditary/genetics
- Neoplastic Syndromes, Hereditary/pathology
- Ovarian Neoplasms/diagnosis
- Ovarian Neoplasms/genetics
- Ovarian Neoplasms/pathology
- Prognosis
- Rhabdomyosarcoma, Embryonal/diagnosis
- Rhabdomyosarcoma, Embryonal/genetics
- Rhabdomyosarcoma, Embryonal/pathology
- Ribonuclease III/genetics
- Sertoli-Leydig Cell Tumor/diagnosis
- Sertoli-Leydig Cell Tumor/genetics
- Sertoli-Leydig Cell Tumor/pathology
- Sex Cord-Gonadal Stromal Tumors/diagnosis
- Sex Cord-Gonadal Stromal Tumors/genetics
- Sex Cord-Gonadal Stromal Tumors/pathology
- Uterine Cervical Neoplasms/diagnosis
- Uterine Cervical Neoplasms/genetics
- Uterine Cervical Neoplasms/pathology
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Affiliation(s)
- Colin J R Stewart
- Department of Histopathology, King Edward Memorial Hospital, School for Women's and Infants' Health, University of Western Australia, Subiaco, Perth, Western Australia 6008, Australia.
| | - Adrian Charles
- Department of Anatomical Pathology, Sidra Medical and Research Center, PO Box 26999, Doha, Qatar
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, Quebec, Canada; Department of Oncology, McGill University, Montreal, Quebec, Canada; Department of Medical Genetics, Jewish General Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Cancer Genetics Laboratory, Lady Davis Institute, Montreal, Quebec H3T 1E2, Canada
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Rare non-epithelial ovarian neoplasms: Pathology, genetics and treatment. Gynecol Oncol 2016; 142:190-198. [PMID: 27079213 DOI: 10.1016/j.ygyno.2016.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 03/25/2016] [Accepted: 04/03/2016] [Indexed: 11/23/2022]
Abstract
Rare non-epithelial ovarian neoplasms have posed management challenges for many years. Their rarity means that most specialist practitioners will see one such case every several years, and most generalists may never see a case. The first step in management is to establish the correct diagnosis and this may necessitate specialist pathology review. Here, we review recent developments in the pathology, genetics and treatment of small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) and sex cord-stromal tumours. Pathologically, these tumours often display morphological overlap with other neoplasms; for example, SCCOHT overlaps with many other "small round blue cell" tumours. Specific immunohistochemical stains, while useful, may not always be definitive. The discovery of somatic mutations in FOXL2 (adult granulosa cell tumours) and germline and somatic mutations in DICER1 (Sertoli-Leydig cell tumours) and SMARCA4 (SCCOHT) has demonstrated the value of molecular investigation as an adjunct to traditional histopathological approaches. In addition, the presence of germline mutations in a significant proportion of some of these neoplasms points to the need for genetic counselling and testing, offering the prospect of prevention and early diagnosis. Treatment of these rare tumours, as a group, should be on the basis of sound oncological principles, given that level 1 evidence will almost always be lacking. The rationale for experimental therapies must be clearly established. In view of the complex issues involved in the management of these conditions, expert opinion in pathology, genetics and treatment may be essential to offer the patient and her family the best chance of a good outcome.
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Ovarian Sertoli–Leydig cell tumour with rhabdomyosarcoma and borderline mucinous neoplasm. Pathology 2016; 48:278-81. [DOI: 10.1016/j.pathol.2016.02.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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