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Lethongsavarn V, Vieille P, Kikweta Makhama J, Azmani R, Lafrance W, Khneisser P, Truffaut N, Alame M, Genestie C, Gaspar N, Diedhiou A, Croce S, Le Loarer F. DICER1-mutated rhabdomyosarcoma of the ovary with teratoid features. Genes Chromosomes Cancer 2023; 62:746-754. [PMID: 37706559 DOI: 10.1002/gcc.23201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/15/2023] Open
Abstract
DICER1-mutated rhabdomyosarcoma is a rare, emerging entity with a predilection for the gynecologic and genitourinary tracts. We report here a case of DICER1-mutated rhabdomyosarcoma of the ovary in a 14 years old girl which displayed interspersed mature teratoid glands, neuroectodermal rosettes and immature blastematous-like tubes. Morphologically the sarcomatous component predominated, corresponding to a high grade spindle cell rhabdomyosarcoma with botryoid features. Islets of cartilage were present. The sarcomatous proliferation encased the teratoid glands, forming cambium layer-like arrangements. The sarcoma cells were Myogenin and MYOD1 positive, the neuroectodermal rosettes expressed SALL4 along with cytokeratins and EMA and were negative for Inhibin; immature blastematous-like tubes were negative for SALL4 and Inhibin. Whole RNA- and targeted DNA-sequencing revealed two DICER1 mutations in exon 26: c.5113G>A: p.(Glu1705Lys) and exon 12: c.1642C>T: p.(Gln548X). The sarcomatous component harbored a complex genetic profile while the teratoid component was diploid, none of the above displayed abnormality of 12p. DICER1-mutated sarcomas display pathological features similar to embryonal rhabdomyosarcomas, botryoid type. They also display heterogeneous features combining cartilage foci, teratoid mature glands, immature blastematous-like tubes and/or neuroectodermal components. Molecular testing remains necessary to confirm the diagnosis. Further studies need to clarify the nosology of DICER1-mutated sarcomas and devise specific therapeutic strategies.
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Affiliation(s)
- Vincent Lethongsavarn
- Department of Pathology, CHU de la Guadeloupe, Pointe-à-Pitre, France
- University of French West Indies (Universite des Antilles), Faculté de Médecine Hyacinthe Bastaraud, Pointe-à-Pitre, France
| | - Pierre Vieille
- Gynecology-Obstetrics, CHU de la Guadeloupe, Pointe-à-Pitre, France
| | | | - Rihab Azmani
- Bioinformatics, Data and Digital Health Department, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Webert Lafrance
- Department of Oncology, CHU de la Guadeloupe, Pointe-à-Pitre, France
| | - Pierre Khneisser
- Department of Pathology, Institut Gustave Roussy, Villejuif, France
| | | | - Melissa Alame
- Department of Pathology, Institut Bergonie, Bordeaux, France
| | | | - Nathalie Gaspar
- Department of Pediatric Oncology, Institut Gustave Roussy, Villejuif, France
| | | | - Sabrina Croce
- Department of Pathology, Institut Bergonie, Bordeaux, France
- Bordeaux Institute of Oncology, BRIC U1312, INSERM, Université de Bordeaux, Institut Bergonié, Bordeaux, France
| | - François Le Loarer
- Department of Pathology, Institut Bergonie, Bordeaux, France
- Bordeaux Institute of Oncology, BRIC U1312, INSERM, Université de Bordeaux, Institut Bergonié, Bordeaux, France
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2
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Karray A, Boussetta A, Sassi F, Cherifi W, Haouet S, Gargah T. Type II pleuropulmonary blastoma mistaken for rhabdomyosarcoma: A case report. Int J Surg Case Rep 2023; 106:108261. [PMID: 37119756 PMCID: PMC10163632 DOI: 10.1016/j.ijscr.2023.108261] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 04/21/2023] [Accepted: 04/22/2023] [Indexed: 05/01/2023] Open
Abstract
INTRODUCTION Pleuropulmonary blastoma (PPB) is rare, representing 0.3 % of all pediatric cancers. PPB is classified into three subtypes and may progress from type I to types II and III, with a worse prognosis. Given its rarity, the diagnosis is frequently challenging. CASE PRESENTATION We report an occurrence of PPB in a 3-year-old girl, who presented recurrent pneumopathy. Imaging investigations revealed a large solid lesion in the left hemithorax. Biopsy followed by histological analysis suggested rhabdomyosarcoma. The patient received neoadjuvant chemotherapy before proceeding to complete tumor excision. Surgical exploration revealed that the tumor was primitively related to parietal pleura and lower lobe of left lung. Histopathology of the tumor retained a definitive diagnosis of PPB type II. Postoperative course was uneventful, and a cerebral MRI ruled out brain metastasis. Adjuvant chemotherapy was administered. DISCUSSION Clinical expression of PPB is nonspecific and variable. It ranges from a dry cough to respiratory distress. Standard radiography is the first examination to perform and CT is the gold standard for characterization thoracic masses. Surgery and chemotherapy are the pillars of treatment. Indications depend on the tumor type, its extent and its resectability. CONCLUSION PPB is an aggressive tumor that occurs only in children. Due to the rarity of PPB, evidence on optimal treatment is still insufficient. Careful follow-up is necessary searching for local recurrence or metastasis.
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Affiliation(s)
- Amina Karray
- Pediatric Department, Charles Nicolle Hospital, Tunis, Tunisia; University of Tunis El Manar-Faculty of Medicine of Tunis, Tunis, Tunisia.
| | - Abir Boussetta
- Pediatric Department, Charles Nicolle Hospital, Tunis, Tunisia; University of Tunis El Manar-Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Farah Sassi
- Department of Pathology, Rabta Hospital, Tunis, Tunisia; University of Tunis El Manar-Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Walid Cherifi
- University of Tunis El Manar-Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Slim Haouet
- Department of Pathology, Rabta Hospital, Tunis, Tunisia; University of Tunis El Manar-Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Tahar Gargah
- Pediatric Department, Charles Nicolle Hospital, Tunis, Tunisia; University of Tunis El Manar-Faculty of Medicine of Tunis, Tunis, Tunisia.
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Kommoss FKF, Chong AS, Chong AL, Pfaff E, Jones DTW, Hiemcke-Jiwa LS, Kester LA, Flucke U, Gessler M, Schrimpf D, Sahm F, Clarke BA, Stewart CJR, Wang Y, Gilks CB, Kommoss F, Huntsman DG, Schüller U, Koelsche C, Glenn McCluggage W, von Deimling A, Foulkes WD. Genomic characterization of DICER1-associated neoplasms uncovers molecular classes. Nat Commun 2023; 14:1677. [PMID: 36966138 PMCID: PMC10039902 DOI: 10.1038/s41467-023-37092-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 02/28/2023] [Indexed: 03/27/2023] Open
Abstract
DICER1 syndrome is a tumor predisposition syndrome that is associated with up to 30 different neoplastic lesions, usually affecting children and adolescents. Here we identify a group of mesenchymal tumors which is highly associated with DICER1 syndrome, and molecularly distinct from other DICER1-associated tumors. This group of DICER1-associated mesenchymal tumors encompasses multiple well-established clinicopathological tumor entities and can be further divided into three clinically meaningful classes designated "low-grade mesenchymal tumor with DICER1 alteration" (LGMT DICER1), "sarcoma with DICER1 alteration" (SARC DICER1), and primary intracranial sarcoma with DICER1 alteration (PIS DICER1). Our study not only provides a combined approach to classify DICER1-associated neoplasms for improved clinical management but also suggests a role for global hypomethylation and other recurrent molecular events in sarcomatous differentiation in mesenchymal tumors with DICER1 alteration. Our results will facilitate future investigations into prognostication and therapeutic approaches for affected patients.
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Affiliation(s)
- Felix K F Kommoss
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Anne-Sophie Chong
- Department of Human Genetics, McGill University, Montreal, QC, Canada
- Cancer Axis, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Molecular Mechanisms and Experimental Therapy in Oncology Program (Oncobell), Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Avinguda de la Granvia de L'Hospitalet, Barcelona, Spain
| | - Anne-Laure Chong
- Department of Human Genetics, McGill University, Montreal, QC, Canada
- Cancer Axis, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Elke Pfaff
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Department of Pediatric Oncology, Hematology and Immunology, Heidelberg University Hospital, Heidelberg, Germany
| | - David T W Jones
- Hopp Children's Cancer Center Heidelberg (KiTZ), Heidelberg, Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Laura S Hiemcke-Jiwa
- Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lennart A Kester
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Uta Flucke
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Manfred Gessler
- Theodor-Boveri-Institute/Biocenter, Developmental Biochemistry, Würzburg University & Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Daniel Schrimpf
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Felix Sahm
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Blaise A Clarke
- Department of Pathology, University Health Network, Toronto, ON, Canada
| | - Colin J R Stewart
- Department of Anatomical Pathology, King Edward Memorial Hospital, Subiaco, WA, Australia
- School for Women's and Infants' Health, University of Western Australia, Perth, WA, Australia
| | - Yemin Wang
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - C Blake Gilks
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Friedrich Kommoss
- Institute of Pathology, Medizin Campus Bodensee, Friedrichshafen, Germany
| | - David G Huntsman
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
- Department of Molecular Oncology, British Columbia Cancer Research Institute, Vancouver, BC, Canada
| | - Ulrich Schüller
- Institute of Neuropathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Research Institute Children's Cancer Center Hamburg, Hamburg, Germany
| | - Christian Koelsche
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - William D Foulkes
- Department of Human Genetics, McGill University, Montreal, QC, Canada.
- Cancer Axis, Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
- Cancer Research Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.
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Jitpasutham T, Faquin WC, Torous VF, Nosé V. Thyroblastoma: A DICER1-associated embryonal neoplasm and fine needle aspiration diagnostic criteria. Diagn Cytopathol 2023; 51:E142-E148. [PMID: 36688366 DOI: 10.1002/dc.25105] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/24/2023]
Abstract
Thyroblastoma is a rare, aggressive embryonal thyroid neoplasm associated with DICER1 mutation. It usually presents as a rapidly growing thyroid mass diffusely infiltrating the thyroid lobes and extending into perithyroidal tissue. Most thyroblastomas were initially diagnosed as malignant teratoma or carcinosarcoma. The cytologic features of thyroblastoma have not been well documented. Here, we present the cytological findings of a case of thyroblastoma in a 19-year-old female with a dominant solid left thyroid nodule. A fine needle aspiration biopsy of the mass revealed a highly cellular aspirate composed of crowded, atypical, high nuclear to cytoplasmic ratio epithelial cells, arranged in a variety of architectural patterns including rosette-like microfollicular, solid, and morular. In addition, the background contains a minor population of atypical mesenchymal cells. The cytologic differential diagnosis of thyroblastoma includes primary thyroid neoplasms such as adenomatous nodule, follicular adenoma, follicular carcinoma, and poorly differentiated thyroid carcinoma as well as metastatic carcinoma.
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Affiliation(s)
- Tikamporn Jitpasutham
- Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Department of Pathology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - William C Faquin
- Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Vanda F Torous
- Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Vania Nosé
- Department of Pathology, Massachusetts General Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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