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Molecular Signature of Biological Aggressiveness in Clear Cell Sarcoma of the Kidney (CCSK). Int J Mol Sci 2023; 24:ijms24043743. [PMID: 36835166 PMCID: PMC9964999 DOI: 10.3390/ijms24043743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/16/2023] Open
Abstract
Clear cell sarcoma of the kidney (CCSK) is a rare pediatric renal tumor with a worse prognosis than Wilms' tumor. Although recently, BCOR internal tandem duplication (ITD) has been found as a driver mutation in more than 80% of cases, a deep molecular characterization of this tumor is still lacking, as well as its correlation with the clinical course. The aim of this study was to investigate the differential molecular signature between metastatic and localized BCOR-ITD-positive CCSK at diagnosis. Whole-exome sequencing (WES) and whole-transcriptome sequencing (WTS) were performed on six localized and three metastatic BCOR-ITD-positive CCSKs, confirming that this tumor carries a low mutational burden. No significant recurrences of somatic or germline mutations other than BCOR-ITD were identified among the evaluated samples. Supervised analysis of gene expression data showed enrichment of hundreds of genes, with a significant overrepresentation of the MAPK signaling pathway in metastatic cases (p < 0.0001). Within the molecular signature of metastatic CCSK, five genes were highly and significantly over-expressed: FGF3, VEGFA, SPP1, ADM, and JUND. The role of FGF3 in the acquisition of a more aggressive phenotype was investigated in a cell model system obtained by introducing the ITD into the last exon of BCOR by Crispr/Cas9 gene editing of the HEK-293 cell line. Treatment with FGF3 of BCOR-ITD HEK-293 cell line induced a significant increase in cell migration versus both untreated and scramble cell clone. The identification of over-expressed genes in metastatic CCSKs, with a particular focus on FGF3, could offer new prognostic and therapeutic targets in more aggressive cases.
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2
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Role of Cyclin D1 and BCOR Immunohistochemistry in Differentiating Clear Cell Sarcoma of Kidney From its Mimics. J Pediatr Hematol Oncol 2021; 43:294-300. [PMID: 34673711 DOI: 10.1097/mph.0000000000002262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/21/2021] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIM Clear cell sarcoma of kidney (CCSK) is the second most common pediatric renal malignancy, constituting ∼3% of renal tumors. Due to its morphologic diversity, the diagnosis of CCSK is often challenging. Recent studies have identified internal tandem duplication of BCL6 corepressor (BCOR) gene in CCSKs which coupled with cyclin D1 immunoreactivity, is helpful in differentiating it from its mimics, particularly blastema-rich Wilms tumor (WT), malignant rhabdoid tumor (MRT), and congenital mesoblastic nephroma (CMN). We aimed to evaluate the utility of cyclin D1 and BCOR immunohistochemistry in differentiating CCSK from its morphologic mimics. MATERIALS AND METHODS Our cohort comprised of 38 pediatric renal tumors which included CCSK (n=18), WT (n=10), MRT (n=5), and CMN (n=5) cases. A detailed clinicopathologic analysis was performed, and tissue microarray were constructed for CCSK and WT, while MRT and CMN tumors were individually stained. RESULTS The age ranged from 2 months to 16 years with male:female ratio of 3:1. Strong, diffuse nuclear immunoreactivity for cyclin D1 and BCOR was noted in 61% (n=11/18) and 83% (n=15/18) of CCSK, respectively, while it was significantly less in WT (n=3/10 for cyclin D1) (n=2/10 for BCOR). None of the MRT and CMN examples demonstrated any immunoreactivity. Interestingly, only the blastemal component of WTs showed distinct, rare nuclear immunoreactivity for cyclin D1 or BCOR and the combination of these was never positive in a given case. CONCLUSION Our results provide evidence that concurrent immunopositivity with cyclin D1 and BCOR is helpful in distinguishing CCSK from its morphologic mimics.
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Abstract
Renal tumors are rare in the neonatal period. Although some may be detected prenatally, a greater proportion present after birth, most often with a palpable abdominal mass with or without other associated symptoms. Cross-sectional imaging is typically followed by radical nephrectomy to make a specific histologic diagnosis to determine the need for additional therapy. This article reviews the clinical presentation, workup, treatment, and outcomes for neonates with some of the more common renal tumors seen in this population.
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Affiliation(s)
- Sei-Gyung K Sze
- Maine Children's Cancer Program, Department of Pediatrics, Maine Medical Center, Tufts School of Medicine, 100 Campus Drive, Suite 107, Scarborough, ME 04074, USA.
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4
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Micci F, Heim S, Panagopoulos I. Molecular pathogenesis and prognostication of "low-grade'' and "high-grade" endometrial stromal sarcoma. Genes Chromosomes Cancer 2020; 60:160-167. [PMID: 33099834 PMCID: PMC7894482 DOI: 10.1002/gcc.22907] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022] Open
Abstract
Endometrial stromal sarcomas (ESS) are a heterogeneous group of rare mesenchymal cancers. Considerable knowledge has been gained in recent years about the molecular characteristics of these cancers, which helps to classify them in a more meaningful manner leading to improved diagnosis, prognostication, and treatment. According to this classification, ESS is now grouped as low‐ or high‐grade. ESS may have overlapping clinical presentation, morphology, and immunohistochemical profile. Their genetic characteristics allow subdivision of many of them depending on which pathogenetically important fusion genes they carry, but clearly much more needs to be unraveled in this regard. We here provide an overview of the molecular pathogenetic knowledge gained so far on low‐ and high‐grade ESS.
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Affiliation(s)
- Francesca Micci
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, Oslo, Norway
| | - Sverre Heim
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ioannis Panagopoulos
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, Oslo, Norway
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5
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Abstract
Molecular characterization has led to advances in the understanding of pediatric renal tumors, including the association of pediatric cystic nephromas with DICER1 tumor syndrome, the metanephric family of tumors with somatic BRAF mutations, the characterization of ETV6-NTRK3-negative congenital mesoblastic nephromas, the expanded spectrum of gene fusions in translocation renal cell carcinoma, the relationship of clear cell sarcoma of the kidney with other BCOR-altered tumors, and the pathways affected by SMARCB1 alterations in rhabdoid tumors of the kidney. These advances have implications for diagnosis, classification, and treatment of pediatric renal tumors.
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6
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Chong WC, Cain JE. Lessons learned from the developmental origins of childhood renal cancer. Anat Rec (Hoboken) 2019; 303:2561-2577. [DOI: 10.1002/ar.24315] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 08/14/2019] [Accepted: 10/05/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Wai Chin Chong
- Centre for Cancer ResearchHudson Institute of Medical Research Clayton Victoria Australia
- Department of Molecular and Translational Medicine, School of Medicine, Nursing and Health SciencesMonash University Clayton Victoria Australia
| | - Jason E. Cain
- Centre for Cancer ResearchHudson Institute of Medical Research Clayton Victoria Australia
- Department of Molecular and Translational Medicine, School of Medicine, Nursing and Health SciencesMonash University Clayton Victoria Australia
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7
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Abstract
BCOR is a gene that encodes for an epigenetic regulator involved in the specification of cell differentiation and body structure development and takes part in the noncanonical polycomb repressive complex 1. This review provides a comprehensive summary of BCOR’s involvement in oncology, illustrating that various BCOR aberrations, such as the internal tandem duplications of the PCGF Ub-like fold discriminator domain and different gene fusions (mainly BCOR–CCNB3, BCOR–MAML3 and ZC3H7B–BCOR), represent driver elements of various sarcomas such as clear cell sarcoma of the kidney, primitive mesenchymal myxoid tumor of infancy, small round blue cell sarcoma, endometrial stromal sarcoma and histologically heterogeneous CNS neoplasms group with similar genomic methylation patterns known as CNS-HGNET-BCOR. Furthermore, other BCOR alterations (often loss of function mutations) recur in a large variety of mesenchymal, epithelial, neural and hematological tumors, suggesting a central role in cancer evolution.
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Affiliation(s)
- Annalisa Astolfi
- 'Giorgio Prodi' Cancer Research Center, University of Bologna, 40138 Bologna, Italy
| | - Michele Fiore
- Pediatric Oncology & Hematology Unit 'Lalla Seràgnoli', S Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - Fraia Melchionda
- Pediatric Oncology & Hematology Unit 'Lalla Seràgnoli', S Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - Valentina Indio
- 'Giorgio Prodi' Cancer Research Center, University of Bologna, 40138 Bologna, Italy
| | - Salvatore N Bertuccio
- Pediatric Oncology & Hematology Unit 'Lalla Seràgnoli', S Orsola-Malpighi Hospital, 40138 Bologna, Italy
| | - Andrea Pession
- Pediatric Oncology & Hematology Unit 'Lalla Seràgnoli', S Orsola-Malpighi Hospital, 40138 Bologna, Italy.,Department of Medical & Surgical Sciences, University of Bologna, S Orsola-Malpighi Hospital, 40138 Bologna, Italy
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8
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Muyi MMD, Bei XMD, Weiling CMD, Jianming SMD. Ultrasonic Imaging of Clear Cell Sarcoma of Kidney: A Case Report. ADVANCED ULTRASOUND IN DIAGNOSIS AND THERAPY 2019. [DOI: 10.37015/audt.2019.190803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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9
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Endometrial stromal sarcomas and related neoplasms: new developments and diagnostic considerations. Pathology 2018; 50:162-177. [DOI: 10.1016/j.pathol.2017.11.086] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 11/05/2017] [Indexed: 12/21/2022]
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10
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Kenny C, McDonagh N, Lazaro A, O'Meara E, Klinger R, O'Connor D, Roche F, Hokamp K, O'Sullivan MJ. Dysregulated mitogen-activated protein kinase signalling as an oncogenic basis for clear cell sarcoma of the kidney. J Pathol 2018; 244:334-345. [PMID: 29243812 DOI: 10.1002/path.5020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 11/30/2017] [Accepted: 12/08/2017] [Indexed: 01/06/2023]
Abstract
The oncogenic mechanisms and tumour biology underpinning clear cell sarcoma of the kidney (CCSK), the second commonest paediatric renal malignancy, are poorly understood and currently, therapy depends heavily on doxorubicin with cardiotoxic side-effects. Previously, we characterized the balanced t(10;17)(q22;p13) chromosomal translocation, identified at that time as the only recurrent genetic aberration in CCSK. This translocation results in an in-frame fusion of the genes YWHAE (encoding 14-3-3ϵ) and NUTM2, with a somatic incidence of 12%. Clinico-pathological features of that cohort suggested that this aberration might be associated with higher stage and grade disease. Since no primary CCSK cell line exists, we generated various stably transfected cell lines containing doxycycline-inducible HA-tagged YWHAE-NUTM2, in order to study the effect of expressing this transcript. 14-3-3ϵ-NUTM2-expressing cells exhibited significantly greater cell migration compared to isogenic controls. Gene and protein expression studies were indicative of dysregulated MAPK/PI3K-AKT signalling, and by blocking these pathways using neutralizing antibodies, the migratory advantage conferred by the transcript was abrogated. Importantly, CCSK tumour samples similarly show up-regulation/activation of these pathways. These results support the oncogenic role of 14-3-3ϵ-NUTM2 in CCSK and provide avenues for the exploration of novel therapeutic approaches. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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MESH Headings
- 14-3-3 Proteins/genetics
- 14-3-3 Proteins/metabolism
- Animals
- Cell Movement
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/metabolism
- Cell Transformation, Neoplastic/pathology
- Gene Expression Regulation, Enzymologic
- Gene Expression Regulation, Neoplastic
- Gene Fusion
- HEK293 Cells
- Humans
- Kidney Neoplasms/enzymology
- Kidney Neoplasms/genetics
- Kidney Neoplasms/pathology
- Mice
- Mitogen-Activated Protein Kinases/genetics
- Mitogen-Activated Protein Kinases/metabolism
- NIH 3T3 Cells
- Oncogene Proteins, Fusion/genetics
- Oncogene Proteins, Fusion/metabolism
- Phosphatidylinositol 3-Kinase/metabolism
- Proto-Oncogene Proteins c-akt/metabolism
- Sarcoma, Clear Cell/enzymology
- Sarcoma, Clear Cell/genetics
- Sarcoma, Clear Cell/pathology
- Signal Transduction
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Affiliation(s)
- Colin Kenny
- School of Medicine, University of Dublin, Trinity College, Dublin, Ireland
| | - Naomi McDonagh
- School of Medicine, University of Dublin, Trinity College, Dublin, Ireland
| | - Antonio Lazaro
- School of Medicine, University of Dublin, Trinity College, Dublin, Ireland
| | - Elaine O'Meara
- School of Medicine, University of Dublin, Trinity College, Dublin, Ireland
| | - Rut Klinger
- Conway Institute, University College Dublin, Belfield, Dublin, Ireland
| | - Darran O'Connor
- Conway Institute, University College Dublin, Belfield, Dublin, Ireland
| | - Fiona Roche
- School of Genetics and Microbiology, University of Dublin, Trinity College, Dublin, Ireland
| | - Karsten Hokamp
- School of Genetics and Microbiology, University of Dublin, Trinity College, Dublin, Ireland
| | - Maureen J O'Sullivan
- School of Medicine, University of Dublin, Trinity College, Dublin, Ireland
- Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
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Wong MK, Ng CCY, Kuick CH, Aw SJ, Rajasegaran V, Lim JQ, Sudhanshi J, Loh E, Yin M, Ma J, Zhang Z, Iyer P, Loh AHP, Lian DWQ, Wang S, Goh SGH, Lim TH, Lim AST, Ng T, Goytain A, Loh AHL, Tan PH, Teh BT, Chang KTE. Clear cell sarcomas of the kidney are characterised by BCOR
gene abnormalities, including exon 15 internal tandem duplications and BCOR-CCNB3
gene fusion. Histopathology 2017; 72:320-329. [DOI: 10.1111/his.13366] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 08/16/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Meng K Wong
- VIVA-KKH Paediatric Brain and Solid Tumour Laboratory; KK Women's and Children's Hospital; Singapore
| | - Cedric C Y Ng
- Laboratory of Cancer Epigenome; National Cancer Centre; Singapore
| | - Chik H Kuick
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore
| | - Sze J Aw
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore
- Department of Anatomical Pathology; Singapore General Hospital; Singapore
| | | | - Jing Q Lim
- Laboratory of Cancer Epigenome; National Cancer Centre; Singapore
| | - Jain Sudhanshi
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore
| | - Eva Loh
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore
| | - Minzhi Yin
- Department of Pathology; Shanghai Children's Medical Centre; Shanghai China
| | - Jing Ma
- Department of Pathology; Shanghai Children's Medical Centre; Shanghai China
| | - Zhongde Zhang
- Department of Pathology; Shanghai Children's Medical Centre; Shanghai China
| | - Prasad Iyer
- Paediatric Haematology-Oncology Service; Singapore
| | - Amos H P Loh
- VIVA-KKH Paediatric Brain and Solid Tumour Laboratory; KK Women's and Children's Hospital; Singapore
- Department of Paediatric Surgery; KK Women's and Children's Hospital; Singapore
- Duke-NUS Medical School; Singapore
| | - Derrick W Q Lian
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore
- Duke-NUS Medical School; Singapore
| | - Shi Wang
- Department of Pathology; National University Health System; Singapore
| | - Shaun G H Goh
- Department of Pathology; National University Health System; Singapore
| | - Tse H Lim
- Department of Molecular Pathology; Singapore General Hospital; Singapore
| | - Alvin S T Lim
- Department of Molecular Pathology; Singapore General Hospital; Singapore
| | - Tony Ng
- Department of Pathology; Vancouver General Hospital and University of British Columbia; Vancouver British Columbia Canada
| | - Angela Goytain
- Department of Pathology; Vancouver General Hospital and University of British Columbia; Vancouver British Columbia Canada
| | - Alwin H L Loh
- Department of Anatomical Pathology; Singapore General Hospital; Singapore
- Duke-NUS Medical School; Singapore
| | - Puay H Tan
- Department of Anatomical Pathology; Singapore General Hospital; Singapore
- Duke-NUS Medical School; Singapore
| | - Bin T Teh
- Laboratory of Cancer Epigenome; National Cancer Centre; Singapore
- Duke-NUS Medical School; Singapore
| | - Kenneth T E Chang
- VIVA-KKH Paediatric Brain and Solid Tumour Laboratory; KK Women's and Children's Hospital; Singapore
- Department of Pathology and Laboratory Medicine; KK Women's and Children's Hospital; Singapore
- Duke-NUS Medical School; Singapore
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12
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Kenny C, Bausenwein S, Lazaro A, Furtwängler R, Gooskens SLM, van den Heuvel Eibrink M, Vokuhl C, Leuschner I, Graf N, Gessler M, O'Sullivan MJ. Mutually exclusive BCOR internal tandem duplications and YWHAE-NUTM2 fusions in clear cell sarcoma of kidney: not the full story. J Pathol 2016; 238:617-20. [PMID: 27000436 DOI: 10.1002/path.4693] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 12/31/2015] [Accepted: 01/21/2016] [Indexed: 11/09/2022]
Abstract
Internal tandem duplication within the BCOR gene sequence that encodes the PUFD domain, important in the formation of the non-canonical or variant polycomb repressor complex 1 (v-PRC1), was very recently described in 100% of 20 clear cell sarcomas of kidney (CCSKs). None of those 20 cases bore the YWHAE-NUTM2 transcript, previously described by us in CCSK, and which constitutes the only other recurrent genetic aberration observed in CCSK, prompting consideration that these mutations might be mutually exclusive in CCSK. We analysed a cohort of 159 CCSKs and can now not only confirm that there is indeed mutual exclusivity of these BCOR and YWHAE mutations, but also show that a substantial proportion (in this series 11.8%) of CCSKs bear neither mutation when tested by these assays, raising the possibility of distinct aetiologies for subsets of CCSK. Clinical differences observed between the subsets support this notion. As CCSK may show poor chemo-responsiveness, and current treatment protocols mandate the use of doxorubicin with its associated side-effects, advances in understanding the disease biology with a view to more targeted and personalized treatment is a pressing need.
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Affiliation(s)
- Colin Kenny
- The National Children's Research Centre, Oncology Division, Gate 5, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland
| | - Sabrina Bausenwein
- Theodor-Boveri-Institute/Biocenter, Developmental Biochemistry, and Comprehensive Cancer Center Mainfranken, Wuerzburg University, 97074 Wuerzburg, Germany
| | - Antonio Lazaro
- The National Children's Research Centre, Oncology Division, Gate 5, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland
| | - Rhoikos Furtwängler
- Department of Pediatric Oncology and Hematology, Saarland University Hospital, 66421, Homburg, Germany
| | - Saskia L M Gooskens
- Princess Maxima Center for Pediatric Oncology/Hematology, Utrecht, The Netherlands
| | | | - Christian Vokuhl
- Kiel Paediatric Cancer Registry, Christian Albrechts University, 24105, Kiel, Germany
| | - Ivo Leuschner
- Kiel Paediatric Cancer Registry, Christian Albrechts University, 24105, Kiel, Germany
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University Hospital, 66421, Homburg, Germany
| | - Manfred Gessler
- Theodor-Boveri-Institute/Biocenter, Developmental Biochemistry, and Comprehensive Cancer Center Mainfranken, Wuerzburg University, 97074 Wuerzburg, Germany
| | - Maureen J O'Sullivan
- The National Children's Research Centre, Oncology Division, Gate 5, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.,Histology Laboratory, Our Lady's Children's Hospital, Crumlin, Dublin 12, Ireland.,University of Dublin, Trinity College, Dublin 2, Ireland
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13
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Gooskens SL, Kenny C, Lazaro A, O'Meara E, van Tinteren H, Spreafico F, Vujanic G, Leuschner I, Coulomb-L'Herminé A, Perotti D, de Camargo B, Bergeron C, Acha García T, Tanaka M, Pieters R, Pritchard-Jones K, Graf N, van den Heuvel-Eibrink MM, O'Sullivan MJ. The clinical phenotype of YWHAE-NUTM2B/E positive pediatric clear cell sarcoma of the kidney. Genes Chromosomes Cancer 2016; 55:143-7. [PMID: 26542179 DOI: 10.1002/gcc.22320] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 09/19/2015] [Accepted: 09/21/2015] [Indexed: 11/09/2022] Open
Abstract
Clear cell sarcoma of the kidney (CCSK) although uncommon, is the second most frequent renal malignancy of childhood. Until now, the sole recurrent genetic aberration identified in CCSKs is t(10;17)(q22;p13), which gives rise to a fusion transcript of YWHAE and NUTM2B/E. So far, the clinical relevance of this fusion transcript is unknown. The aim of this descriptive study was to determine the clinical phenotype of t(10;17)(q22;p13) positive CCSKs. Snap-frozen tissues, formalin-fixed paraffin-embedded tissues or RNA previously extracted from CCSK samples throughout European, North-American and Japanese study groups were screened by RT-PCR for the YWHAE-NUTM2B/E transcript. Clinical characteristics, tumor characteristics, and outcome of patients with and without the fusion transcript were studied. The cohort comprised 51 previously published cases to which were added 139 internationally collected CCSK samples. RNA from 57 of these additionally collected cases was of sufficient quality to be successfully screened for the YWHAE-NUTM2B/E transcript. In total, seven of the 108 cases harbored the fusion transcript. Patients with tumors containing the fusion transcript were relatively young (median age 10 months), had associated low median tumor volumes and stage I disease was not observed in these patients. Two of seven patients relapsed and one of seven patients died of disease. Ranges of values were not overtly different between patients with and without the fusion transcript; however, the number of fusion transcript positive cases turned out to be too small to permit reliable statistical analysis. The current study did not identify an explicit clinical phenotype of CCSK cases harboring the YWHAE-NUTM2B/E fusion transcript.
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Affiliation(s)
- Saskia L Gooskens
- Department of Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Colin Kenny
- National Children's Research Center, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Antonio Lazaro
- National Children's Research Center, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Elaine O'Meara
- National Children's Research Center, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
| | - Harm van Tinteren
- Department of Statistics, Dutch Cancer Institute (NKI-AvL), Amsterdam, The Netherlands
| | - Filippo Spreafico
- Department of Pediatric Hematology and Pediatric Onco-Hematology, Fondazione IRCCS Istituto Tumori, Milano, Italy
| | - Gordan Vujanic
- Department of Pathology, Cardiff University School of Medicine, Heath Park, Cardiff, UK
| | - Ivo Leuschner
- Kiel Pediatric Tumor Registry, Department of Pediatric Pathology, University Schleswig-Holstein, Kiel, Germany
| | - Aurore Coulomb-L'Herminé
- Department of Pathology, Hopitaux Universitaires Est Parisien, Trousseau La Roche-Guyon, Paris, France
| | - Daniela Perotti
- Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milano, Italy
| | - Beatriz de Camargo
- Pediatric Hematology Oncology Program, Instituto Nacional Do Cancer, Rio De Janeiro, Brazil
| | | | - Tomas Acha García
- Department of Pediatric Oncology, Hospital Materno-Infantil, Malaga, Spain
| | - Mio Tanaka
- Department of Diagnostic Pathology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Rob Pieters
- Department of Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Kathy Pritchard-Jones
- Department of Pediatric Hematology and Oncology, Institute of Child Health, University College, London, UK
| | - Norbert Graf
- Department of Pediatric Hematology/Oncology, University Hospital for Children, Homburg, Germany
| | | | - Maureen J O'Sullivan
- National Children's Research Center, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
- Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
- University of Dublin, Trinity College, Dublin, Ireland
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14
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Jet Aw S, Hong Kuick C, Hwee Yong M, Wen Quan Lian D, Wang S, Liang Loh AH, Ling S, Lian Peh G, Yen Soh S, Pheng Loh AH, Hoon Tan P, Tou En Chang K. Novel Karyotypes and Cyclin D1 Immunoreactivity in Clear Cell Sarcoma of the Kidney. Pediatr Dev Pathol 2015; 18:297-304. [PMID: 25751590 DOI: 10.2350/14-12-1581-oa.1] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Pathological diagnosis of clear cell sarcoma of the kidney (CCSK) is challenging as it resembles blastemal Wilms tumor (WT) and other pediatric sarcomas, and does not have any distinctive immunophenotype. The YWHAE-FAM22 translocation t(10;17)(q22;p13) has been reported in a subset of CCSK. This translocation also occurs in high-grade endometrial sarcoma, in which it is associated with cyclin D1 overexpression. Hence we seek to determine YWHAE-FAM22 translocation status and cyclin D1 immunoreactivity in a series of local CCSK cases. Of 8 CCSK cases from 7 patients identified, no CCSK had the YWHAE-FAM22 fusion transcript by reverse transcriptase-polymerase chain reaction. Novel karyotypes were identified for 2 cases: 1 had t(2;13)(q13;q22) and the other t(3:17)(q29;p11.2). Excluding a case with poor tissue section antigenicity, 7 of 7 CCSKs (100%) showed diffuse and strong nuclear cyclin D1 staining. Cyclin D1 immunohistochemistry was also performed on tissue microarrays of other pediatric renal tumors: blastemal areas of 18 WT cases were negative; 6 rhabdoid tumors and 1 metanephric adenoma showed patchy and weak staining; 3 mesoblastic nephromas and 18 of 29 neuroblastomas had positive staining. Cyclin D1 immunohistochemistry helps distinguish CCSK from blastemal WT and metanephric adenoma and rhabdoid tumors, but not from neuroblastomas and mesoblastic nephromas. Cyclin D1 overexpression in CCSK is not contingent on YWHAE-FAM22 translocation, and cyclin D1 inhibition may potentially be explored as a targeted therapeutic strategy in CCSK.
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Affiliation(s)
- Sze Jet Aw
- 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Chik Hong Kuick
- 2 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Min Hwee Yong
- 2 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Derrick Wen Quan Lian
- 2 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Shi Wang
- 3 Department of Pathology, National University Health System, Singapore
| | - Alwin Hwai Liang Loh
- 4 Department of Pathology, Singapore General Hospital, Singapore.,7 Duke-NUS Graduate Medical School, Singapore
| | - Sharon Ling
- 2 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Guat Lian Peh
- 2 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore
| | - Shui Yen Soh
- 5 Haematology-Oncology Service, Department of Paediatric Subspecialties, KK Women's and Children's Hospital, Singapore.,7 Duke-NUS Graduate Medical School, Singapore
| | - Amos Hong Pheng Loh
- 6 Department of Paediatric Surgery, KK Women's and Children's Hospital, Singapore
| | - Puay Hoon Tan
- 1 Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,4 Department of Pathology, Singapore General Hospital, Singapore.,7 Duke-NUS Graduate Medical School, Singapore
| | - Kenneth Tou En Chang
- 2 Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore.,7 Duke-NUS Graduate Medical School, Singapore
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15
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Gooskens SL, Gadd S, Guidry Auvil JM, Gerhard DS, Khan J, Patidar R, Meerzaman D, Chen QR, Hsu CH, Yan C, Nguyen C, Hu Y, Mullighan CG, Ma J, Jennings LJ, de Krijger RR, van den Heuvel-Eibrink MM, Smith MA, Ross N, Gastier-Foster JM, Perlman EJ. TCF21 hypermethylation in genetically quiescent clear cell sarcoma of the kidney. Oncotarget 2015; 6:15828-41. [PMID: 26158413 PMCID: PMC4599240 DOI: 10.18632/oncotarget.4682] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 06/07/2015] [Indexed: 01/31/2023] Open
Abstract
Clear Cell Sarcoma of the Kidney (CCSK) is a rare childhood tumor whose molecular pathogenesis remains poorly understood. We analyzed a discovery set of 13 CCSKs for changes in chromosome copy number, mutations, rearrangements, global gene expression and global DNA methylation. No recurrent segmental chromosomal copy number changes or somatic variants (single nucleotide or small insertion/deletion) were identified. One tumor with t(10;17)(q22;p13) involving fusion of YHWAE with NUTM2B was identified. Integrated analysis of expression and methylation data identified promoter hypermethylation and low expression of the tumor suppressor gene TCF21 (Pod-1/capsulin/epicardin) in all CCSKs except the case with t(10;17)(q22;p13). TARID, the long noncoding RNA responsible for demethylating TCF21, was virtually undetectable in most CCSKs. TCF21 hypermethylation and decreased TARID expression were validated in an independent set of CCSK tumor samples. The presence of significant hypermethylation of TCF21, a transcription factor known to be active early in renal development, supports the hypothesis that hypermethylation of TCF21 and/or decreased TARID expression lies within the pathogenic pathway of most CCSKs. Future studies are needed to functionally verify a tumorigenic role of TCF21 down-regulation and to tie this to the unique gene expression pattern of CCSK.
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Affiliation(s)
- Saskia L. Gooskens
- Department of Pediatric Hematology and Oncology, Erasmus MC - Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Pediatric Oncology, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Samantha Gadd
- Department of Pathology, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine and Robert H. Lurie Cancer Center, Chicago, IL, USA
| | | | | | - Javed Khan
- Genetics Branch, Oncogenomics section, National Cancer Institute, Bethesda, MD, USA
| | - Rajesh Patidar
- Genetics Branch, Oncogenomics section, National Cancer Institute, Bethesda, MD, USA
| | - Daoud Meerzaman
- Computational Genomics Research Group, Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Qing-Rong Chen
- Computational Genomics Research Group, Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Chih Hao Hsu
- Computational Genomics Research Group, Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Chunhua Yan
- Computational Genomics Research Group, Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Cu Nguyen
- Computational Genomics Research Group, Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Ying Hu
- Computational Genomics Research Group, Center for Biomedical Informatics and Information Technology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles G. Mullighan
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Jing Ma
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Lawrence J. Jennings
- Department of Pathology, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine and Robert H. Lurie Cancer Center, Chicago, IL, USA
| | - Ronald R. de Krijger
- Department of Pathology, Josephine Nefkens Institute, Erasmus MC, Rotterdam, The Netherlands
- Department of Pathology, Reinier de Graaf Hospital, Delft, The Netherlands
| | | | - Malcolm A. Smith
- Cancer Therapy Evaluation Program, National Cancer Institute, Bethesda, MD, USA
| | - Nicole Ross
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH, USA
| | - Julie M. Gastier-Foster
- Department of Pathology and Laboratory Medicine, Nationwide Children's Hospital, Ohio State University College of Medicine, Columbus, OH, USA
| | - Elizabeth J. Perlman
- Department of Pathology, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University's Feinberg School of Medicine and Robert H. Lurie Cancer Center, Chicago, IL, USA
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16
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Diaz-Cano SJ. Pathological bases for a robust application of cancer molecular classification. Int J Mol Sci 2015; 16:8655-75. [PMID: 25898411 PMCID: PMC4425102 DOI: 10.3390/ijms16048655] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 04/07/2015] [Indexed: 12/12/2022] Open
Abstract
Any robust classification system depends on its purpose and must refer to accepted standards, its strength relying on predictive values and a careful consideration of known factors that can affect its reliability. In this context, a molecular classification of human cancer must refer to the current gold standard (histological classification) and try to improve it with key prognosticators for metastatic potential, staging and grading. Although organ-specific examples have been published based on proteomics, transcriptomics and genomics evaluations, the most popular approach uses gene expression analysis as a direct correlate of cellular differentiation, which represents the key feature of the histological classification. RNA is a labile molecule that varies significantly according with the preservation protocol, its transcription reflect the adaptation of the tumor cells to the microenvironment, it can be passed through mechanisms of intercellular transference of genetic information (exosomes), and it is exposed to epigenetic modifications. More robust classifications should be based on stable molecules, at the genetic level represented by DNA to improve reliability, and its analysis must deal with the concept of intratumoral heterogeneity, which is at the origin of tumor progression and is the byproduct of the selection process during the clonal expansion and progression of neoplasms. The simultaneous analysis of multiple DNA targets and next generation sequencing offer the best practical approach for an analytical genomic classification of tumors.
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Affiliation(s)
- Salvador J Diaz-Cano
- King's Health Partners, Cancer Studies, King's College Hospital-Viapath, Denmark Hill, London SE5-9RS, UK.
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17
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Mirkovic J, Calicchio M, Fletcher CD, Perez-Atayde AR. Diffuse and strong cyclin D1 immunoreactivity in clear cell sarcoma of the kidney. Histopathology 2015; 67:306-12. [PMID: 25556515 DOI: 10.1111/his.12641] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2014] [Accepted: 12/24/2014] [Indexed: 12/17/2022]
Abstract
AIMS Distinguishing clear cell sarcoma of the kidney (CCSK) from other paediatric malignancies, particularly blastema-rich Wilms tumour (WT) and congenital mesoblastic nephroma (CMN), is challenging. Specific immunohistochemistry for CCSK does not exist, and diagnosis rests upon histopa thology. Recently, the YWHAE-FAM22 rearrange ment, identical to that in endometrial stromal sarcoma (ESS), has been identified in CCSKs. As this fusion results in overexpression of cyclin D1 in ESS, we postulated that overexpression would also occur in CCSK; cyclin D1 immunohistochemistry could then be used to differentiate CCSK from other tumours. The goal of this study was therefore to evaluate the utility of cyclin D1 immunohistochemistry in identifying CCSK and helping to differentiate it from its mimics. METHODS AND RESULTS Cyclin D1 expression was evaluated in 59 renal tumours-CCSK (14), WT (25), rhabdoid tumour (four), Ewing sarcoma (five), and CMN (11)-and four neuroblastomas. All 14 CCSKs showed diffuse and strong reactivity. In contrast, the blastematous component of most WTs showed only rare positive nuclei, that of rhabdoid tumours showed rare to focal immunoreactivity, and that of more than half of CMNs showed weak or focal immunoreactivity. Most Ewing sarcomas and all neuroblastomas showed diffuse moderate to strong staining. CONCLUSIONS Cyclin D1 is most helpful in distinguishing CCSK from WT, rhabdoid tumour, and some CMNs, but not from neuroblastoma or Ewing sarcomas.
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Affiliation(s)
- Jelena Mirkovic
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Department of Pathology, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Monica Calicchio
- Department of Pathology, Boston Children's Hospital, Boston, MA, USA
| | - Christopher D Fletcher
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Antonio R Perez-Atayde
- Department of Pathology, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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18
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Karlsson J, Lilljebjörn H, Holmquist Mengelbier L, Valind A, Rissler M, Øra I, Fioretos T, Gisselsson D. Activation of human telomerase reverse transcriptase through gene fusion in clear cell sarcoma of the kidney. Cancer Lett 2015; 357:498-501. [DOI: 10.1016/j.canlet.2014.11.057] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Revised: 11/25/2014] [Accepted: 11/26/2014] [Indexed: 10/24/2022]
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19
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Affiliation(s)
- Cheng-Han Lee
- Department of Laboratory Medicine and Pathology; Royal Alexandra Hospital; University of Alberta; Edmonton AB Canada
| | - Marisa R Nucci
- Department of Pathology; Brigham and Women's Hospital; Boston MA USA
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20
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High-grade endometrial stromal sarcomas: a clinicopathologic study of a group of tumors with heterogenous morphologic and genetic features. Am J Surg Pathol 2014; 38:1161-72. [PMID: 25133706 DOI: 10.1097/pas.0000000000000256] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The existence of a "high-grade endometrial stromal sarcoma" category of tumors has been a controversial subject owing to, among other things, the difficulty in establishing consistent diagnostic criteria. Currently, the recommended classification for such tumors is undifferentiated uterine/endometrial sarcoma. Interest in this subject has recently increased markedly with the identification of recurrent molecular genetic abnormalities. At Mayo Clinic, a group of neoplasms has been observed that morphologically resemble, either cytologically or architecturally, classic "low-grade" endometrial stromal sarcoma but feature obvious deviations, specifically, 17 tumors with unequivocally high-grade morphology. These high-grade tumors displayed 3 morphologic themes: (1) tumors with a component that is identical to low-grade ESS that transitions abruptly into an obviously higher-grade component; (2) tumors composed exclusively of high-grade cells with uniform nuclear features but with a permeative pattern of infiltration; (3) tumors similar to the second group but with a different, yet characteristic, cytomorphology featuring enlarged round to ovoid cells (larger than those found in low-grade ESS) with smooth nuclear membranes and distinct chromatin clearing but lacking prominent nucleoli. We collected clinicopathologic data, applied immunohistochemical studies, and also tested tumors by fluorescence in situ hybridization for abnormalities in JAZF1, PHF1, YWHAE, and CCND1. Tumors from these 3 groups were found to be immunohistochemically and genetically distinct from one another. Most notable was the fact that category 3 contained all the cases that tested positive for YWHAE rearrangement, did not show any classic translocations for JAZF1, PHF1, or CCND1, often presented at a high stage, and behaved aggressively. This study demonstrates the morphologic, immunophenotypic, and molecular genetic heterogeneity that exists within "undifferentiated endometrial sarcomas" as currently defined and lends credence to the effort of subclassifying some tumors as truly "high-grade endometrial stromal sarcomas." Our study also shows that, in the context of undifferentiated endometrial sarcomas, recognition of cytomorphologic features on routine hematoxylin and eosin-stained sections may be used to select tumors with specific molecular genetic changes-that is, translocations involving YWHAE. Our conclusions will help further efforts towards proper sub-classification of these tumors which will aid in diagnosis and potentially affect clinical management.
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21
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Suzuki S, Tanioka F, Minato H, Ayhan A, Kasami M, Sugimura H. Breakages at YWHAE, FAM22A, and FAM22B loci in uterine angiosarcoma: A case report with immunohistochemical and genetic analysis. Pathol Res Pract 2014; 210:130-4. [DOI: 10.1016/j.prp.2013.09.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 01/27/2023]
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22
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Karlsson J, Holmquist Mengelbier L, Ciornei CD, Naranjo A, O'Sullivan MJ, Gisselsson D. Clear cell sarcoma of the kidney demonstrates an embryonic signature indicative of a primitive nephrogenic origin. Genes Chromosomes Cancer 2014; 53:381-91. [PMID: 24488803 DOI: 10.1002/gcc.22149] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 01/13/2014] [Indexed: 01/08/2023] Open
Abstract
Clear cell sarcoma of the kidney (CCSK) is a tumor affecting children with a median age of 3 years at diagnosis. The cell of origin of CCSK is unknown and data on the molecular changes giving rise to CCSK is scarce. This has hindered the identification of positive diagnostic markers and development of molecularly targeted treatment protocols for CCSK. We have characterized a panel of CCSK to gain information regarding its molecular profile and possible origin. High-resolution genomic analysis with single nucleotide polymorphism array of 37 tumors did not reveal any clues to the mechanisms behind tumor development as remarkably few genetic imbalances were found. Gene expression analysis revealed a highly characteristic gene signature, enriched for pathways involved in embryonic development, including kidney formation. The presence of markers for two different developmental lineages in the embryonic kidney was therefore investigated in the tumor cells. FOXD1 which identifies cells giving rise to stromal elements, and CITED1, a marker for cells primed for nephrogenic epithelial differentiation, were both highly expressed in CCSK. In addition, the early embryonic marker OSR1 was expressed at higher levels in CCSK than in Wilms tumor, normal fetal kidney or adult kidney. As this marker discriminates the intermediate mesoderm from other mesodermal structures, our study could suggest that CCSK arises from a mesodermal cell type that retains the capacity to initiate differentiation towards both nephrons and stroma, but remains locked in a primitive state.
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Affiliation(s)
- Jenny Karlsson
- Department of Clinical Genetics, Lund University, University and Regional Laboratories, Lund, Sweden
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23
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Furtwängler R, Gooskens SL, van Tinteren H, de Kraker J, Schleiermacher G, Bergeron C, de Camargo B, Acha T, Godzinski J, Sandstedt B, Leuschner I, Vujanic GM, Pieters R, Graf N, van den Heuvel-Eibrink MM. Clear Cell Sarcomas of the Kidney registered on International Society of Pediatric Oncology (SIOP) 93-01 and SIOP 2001 protocols: A report of the SIOP Renal Tumour Study Group. Eur J Cancer 2013; 49:3497-506. [PMID: 23880476 DOI: 10.1016/j.ejca.2013.06.036] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Revised: 06/23/2013] [Accepted: 06/26/2013] [Indexed: 01/07/2023]
Affiliation(s)
- R Furtwängler
- Department of Pediatric Hematology/Oncology, University Hospital for Children, Homburg, Germany
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24
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Gooskens SLM, Furtwängler R, Vujanic GM, Dome JS, Graf N, van den Heuvel-Eibrink MM. Clear cell sarcoma of the kidney: a review. Eur J Cancer 2012; 48:2219-26. [PMID: 22579455 DOI: 10.1016/j.ejca.2012.04.009] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2012] [Revised: 03/29/2012] [Accepted: 04/16/2012] [Indexed: 02/07/2023]
Abstract
Clear cell sarcoma of the kidney (CCSK) is a rare renal tumour that is observed most often in children under 3years of age. Only a few large series of CCSK have been reported and patients with CCSK are often included among patients with other types of childhood renal tumours. The purpose of this paper is to review the published series and case reports of CCSK and to create an up-to-date overview of clinical and histological features, genetics, treatment, and outcome.
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Affiliation(s)
- S L M Gooskens
- Department of Pediatric Hematology and Oncology, Erasmus MC-Sophia Children's Hospital, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands
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25
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26
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O'Meara E, Stack D, Lee CH, Garvin AJ, Morris T, Argani P, Han JS, Karlsson J, Gisselson D, Leuschner I, Gessler M, Graf N, Fletcher JA, O'Sullivan MJ. Characterization of the chromosomal translocation t(10;17)(q22;p13) in clear cell sarcoma of kidney. J Pathol 2012; 227:72-80. [DOI: 10.1002/path.3985] [Citation(s) in RCA: 110] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Revised: 12/22/2011] [Accepted: 12/22/2011] [Indexed: 01/06/2023]
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27
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Taguchi K, Kojima Y, Mizuno K, Kamisawa H, Kohri K, Hayashi Y. Molecular Analysis of Clear Cell Sarcoma With Translocation (1;6)(p32.3;q21). Urology 2011; 78:684-6. [DOI: 10.1016/j.urology.2010.12.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Revised: 12/16/2010] [Accepted: 12/21/2010] [Indexed: 11/28/2022]
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28
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Toutain J, VuPhi Y, Doco-Fenzy M, Morice-Picard F, Stanislas S, Laharanne E, Cailley D, Vergnes P, Perel Y, Boccon-Gibod L, Deminiere C, Taine L. Identification of a complex 17q rearrangement in a metanephric stromal tumor. Cancer Genet 2011; 204:340-3. [DOI: 10.1016/j.cancergen.2011.05.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2010] [Revised: 05/02/2011] [Accepted: 05/11/2011] [Indexed: 01/06/2023]
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29
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Cytogenetic and molecular aberrations in endometrial stromal tumors. Hum Pathol 2011; 42:609-17. [DOI: 10.1016/j.humpath.2010.12.005] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Revised: 11/24/2010] [Accepted: 12/02/2010] [Indexed: 12/23/2022]
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30
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Hadley GP, Sheik-Gafoor MH. Clear cell sarcoma of the kidney in children: experience in a developing country. Pediatr Surg Int 2010; 26:345-8. [PMID: 20127337 DOI: 10.1007/s00383-010-2554-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2010] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Clear cell sarcoma of the kidney (CCSK) is a rare tumour comprising 4% of primary renal tumours in children. It has a unique constellation of chromosomal and molecular features and should no longer be viewed as an unfavourable histological variant of Wilms tumour. Little is known of its clinical presentation and pathological profile in children living in a developing country. AIM To describe the clinical and pathological features of CCSK in children in our practice and to identify factors contributing to poor patient outcomes. METHOD A retrospective review of patients with a confirmed diagnosis of CCSK who presented for treatment at a single institution between 1990 and 2008. RESULTS 14 patients fulfilled the inception criteria. They represented 4% of 356 patients presenting with primary renal tumours during the review period. Clinical and radiological features were indistinguishable from Wilms tumour. Tumours were large (Mean mass 1.4 kg; median 0.9 kg) and metastases were common (42%). Lung and lymph node metastases were more common than skeletal disease. Co-morbidity, particularly hypertension (64%) was common. Initial diagnosis by needle biopsy was correct in only two of seven patients (29%) leading to inappropriate neoadjuvant chemotherapy. Overall survival is poor with 57% of patients alive and disease free from 1 to 7 years off treatment. CONCLUSION In a developing country, CCSK is rare and clinically and radiologically indistinguishable from Wilms tumour. Associated hypertension is common. Pretreatment diagnosis is difficult and sampling errors using needle biopsies may be unavoidable. Treatment results are poor and, given the propensity for late recurrence in CCSK, may not be sustained.
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Affiliation(s)
- G P Hadley
- Department of Paediatric Surgery, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Congella, South Africa.
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31
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Abstract
The role of the pathologist has been fundamental in the progress of the treatment of paediatric renal tumours. There are different philosophies in the treatment of these tumours, and there have been many recent advances in the areas of chemotherapy, identification of new entities, prognostic histological criteria following treatment and molecular prognostic and diagnostic features. This review discusses the different approaches of the different treatment protocols from Europe and North America, and reviews staging criteria, prognostic criteria and also the different tumour entities.
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Affiliation(s)
- Gordan M Vujanic
- Paediatric Pathology, School of Medicine, Cardiff University, United Kingdom
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32
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Brownlee NA, Perkins LA, Stewart W, Jackle B, Pettenati MJ, Koty PP, Iskandar SS, Garvin AJ. Recurring translocation (10;17) and deletion (14q) in clear cell sarcoma of the kidney. Arch Pathol Lab Med 2007; 131:446-51. [PMID: 17516747 DOI: 10.5858/2007-131-446-rtadqi] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2006] [Indexed: 11/06/2022]
Abstract
CONTEXT Clear cell sarcoma of the kidney (CCSK) is a prognostically unfavorable renal neoplasm of childhood. Previous cytogenetic studies of CCSK have reported balanced translocations t(10;17)(q22;p13) and t(10;17)(q11;p12). Although the tumor suppressor gene p53 is located at the chromosome 17p13 breakpoint, p53 abnormalities are rarely present in these tumors. OBJECTIVE To identify cytogenetic abnormalities in CCSK and correlate these findings with other clinicopathologic parameters. DESIGN A retrospective review of CCSK patients from 1990 to 2005 was conducted at our medical center. We performed clinical and histologic review, p53 immunohistochemical and classic cytogenetics (or ploidy analysis), and p53 fluorescence in situ hybridization analyses. RESULTS Five male patients (age range, 6 months to 4 years) were identified with cytogenetic abnormalities. Of 3 cytogenetically informative cases, one revealed a clonal balanced translocation t(10;17)(q22;p13) and an interstitial deletion of chromosome 14, del(14)(q24.1q31.1), and the other 2 patients had normal karyotypes. Fluorescence in situ hybridization for p53 in the t(10;17) case revealed no deletion. Immunohistochemical evaluation of p53 demonstrated lack of nuclear protein accumulation in all cases. CONCLUSIONS Together with the published literature, our results indicate that translocation (10;17) and interstitial deletions of chromosome 14q are recurring cytogenetic lesions in CCSK. To date, 3 cases of CCSK or "sarcomatoid Wilms tumors" have been reported to exhibit t(10;17). One previously reported case of CCSK contained deletion 14q. Results of p53 immunohistochemistry and/or p53 fluorescence in situ hybridization in this report suggest lack of mutations or deletions of this tumor suppressor in these CCSK cases. The t(10;17) breakpoint and deletion of chromosome 14q24 suggest that other genes are involved in tumor pathogenesis.
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MESH Headings
- Child, Preschool
- Chromosome Deletion
- Chromosomes, Human, Pair 10
- Chromosomes, Human, Pair 14
- Chromosomes, Human, Pair 17
- DNA, Neoplasm/analysis
- Humans
- In Situ Hybridization, Fluorescence
- Infant
- Kidney Neoplasms/genetics
- Male
- Retrospective Studies
- Sarcoma, Clear Cell/genetics
- Translocation, Genetic
- Tumor Suppressor Protein p53/analysis
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Affiliation(s)
- Noel A Brownlee
- Department of Pathology, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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34
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Berman J. Modern classification of neoplasms: reconciling differences between morphologic and molecular approaches. BMC Cancer 2005; 5:100. [PMID: 16092965 PMCID: PMC1208861 DOI: 10.1186/1471-2407-5-100] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2005] [Accepted: 08/10/2005] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND For over 150 years, pathologists have relied on histomorphology to classify and diagnose neoplasms. Their success has been stunning, permitting the accurate diagnosis of thousands of different types of neoplasms using only a microscope and a trained eye. In the past two decades, cancer genomics has challenged the supremacy of histomorphology by identifying genetic alterations shared by morphologically diverse tumors and by finding genetic features that distinguish subgroups of morphologically homogeneous tumors. DISCUSSION The Developmental Lineage Classification and Taxonomy of Neoplasms groups neoplasms by their embryologic origin. The putative value of this classification is based on the expectation that tumors of a common developmental lineage will share common metabolic pathways and common responses to drugs that target these pathways. The purpose of this manuscript is to show that grouping tumors according to their developmental lineage can reconcile certain fundamental discrepancies resulting from morphologic and molecular approaches to neoplasm classification. In this study, six issues in tumor classification are described that exemplify the growing rift between morphologic and molecular approaches to tumor classification: 1) the morphologic separation between epithelial and non-epithelial tumors; 2) the grouping of tumors based on shared cellular functions; 3) the distinction between germ cell tumors and pluripotent tumors of non-germ cell origin; 4) the distinction between tumors that have lost their differentiation and tumors that arise from uncommitted stem cells; 5) the molecular properties shared by morphologically disparate tumors that have a common developmental lineage, and 6) the problem of re-classifying morphologically identical but clinically distinct subsets of tumors. The discussion of these issues in the context of describing different methods of tumor classification is intended to underscore the clinical value of a robust tumor classification. SUMMARY A classification of neoplasms should guide the rational design and selection of a new generation of cancer medications targeted to metabolic pathways. Without a scientifically sound neoplasm classification, biological measurements on individual tumor samples cannot be generalized to class-related tumors, and constitutive properties common to a class of tumors cannot be distinguished from uninformative data in complex and chaotic biological systems. This paper discusses the importance of biological classification and examines several different approaches to the specific problem of tumor classification.
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Affiliation(s)
- Jules Berman
- U.S. National Cancer Institute, Cancer Diagnosis Program, Bethesda, USA.
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