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Castle AMR, Empringham B, Pinto LM, Villani A, Kanwar N, Abbott LS, Sawyer SL. Rhabdomyosarcoma as the first presentation in Neurofibromatosis Type 1: case series and review of the literature. Pediatr Hematol Oncol 2023:1-10. [PMID: 36625737 DOI: 10.1080/08880018.2022.2153951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Neurofibromatosis Type 1 (NF1) is a neurocutaneous syndrome characterized by multiple café-au-lait macules, neurofibromas, and predisposition to malignancies, including rhabdomyosarcomas (RMS). Somatic NF1 mutations occur in RMS and other cancers, and ∼1% of patients with RMS have NF1. We describe three patients who presented prior to one year of age with RMS and were subsequently diagnosed with NF1. Compared to sporadic RMS, patients with this cancer predisposition syndrome are diagnosed younger, genitourinary sites are more common, and tumors are almost exclusively the embryonal subtype. Genomic sequencing of the tumor was initiated in one patient, and we identified a second sequence variant in NF1. The identification of molecular drivers in tumors is changing the nature of pediatric oncology by informing therapeutics targeted to specific molecular pathways and selecting patients who are likely to harbor germline variants in cancer predisposition genes who would benefit from a Medical Genetics assessment.
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Affiliation(s)
- Alison M R Castle
- Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Brianna Empringham
- Division of Hematology/Oncology, Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Lisa M Pinto
- Division of Hematology/Oncology, Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Anita Villani
- Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Nisha Kanwar
- Division of Genome Diagnostics, Department of Paediatric Laboratory Medicine and Pathobiology, The Hospital for Sick Children, Toronto, Canada
| | - Lesleigh S Abbott
- Division of Hematology/Oncology, Department of Pediatrics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada
| | - Sarah L Sawyer
- Department of Genetics, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.,Children's Hospital of Eastern Ontario (CHEO) Research Institute, University of Ottawa, Ottawa, Canada
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Hicks SR, Cozart AK, Bellus GA, Schneider KW. A Retrospective Chart Review of Children in Neurocutaneous Clinic Who May Benefit from Further Evaluation Beyond Neurofibromatosis Type I. Cancer Prev Res (Phila) 2021; 14:471-478. [PMID: 33431377 DOI: 10.1158/1940-6207.capr-20-0373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/03/2020] [Accepted: 01/05/2021] [Indexed: 11/16/2022]
Abstract
While most individuals with a clinical diagnosis of Neurofibromatosis type 1 (NF1) have a detectable pathogenic variant in the NF1 gene, other conditions have phenotypic features overlapping with NF1. Without molecular confirmation, individuals may be misdiagnosed and have a different underlying condition. Namely, if a child has constitutional mismatch repair deficiency (CMMRD), early detection and prevention strategies for cancer risk would include surveillance recommendations not typically recommended for children with NF1. This study aimed to explore phenotypes of individuals with a clinical diagnosis of NF1 to identify subpopulations who may benefit from further genetic counseling or testing for an alternate diagnosis. Retrospective review of 240 medical records of children who attended a neurocutaneous clinic identified 135 children with a molecularly confirmed pathogenic variant in NF1 or autosomal dominant pattern of clinical NF1 ("controls") and 102 children deemed "at-risk" for another condition like CMMRD. Clinical presentation, family history of NF1, personal history of cancer, and family history of cancer were compared. When comparing clinical presentation, family history, and cancer history, minimal statistical differences were found, indicating that the at-risk population appears clinically indistinguishable from those with a clear diagnosis of NF1. Given the lack of distinguishable features between the at-risk and control population, this study suggests that tiered genetic testing for all individuals being evaluated for NF1 may be beneficial for identifying patients who may be misdiagnosed with NF1 and subsequently mismanaged. This study suggests that at-risk population with a suspected NF1 diagnosis may benefit from further evaluation. Correct diagnosis of constitutional mismatch repair deficiency is crucial to diagnose cancer at an early stage or prevent cancer from occurring. PREVENTION RELEVANCE: This study suggests that at-risk population with a suspected NF1 diagnosis may benefit from further evaluation. Correct diagnosis of constitutional mismatch repair deficiency is crucial to diagnose cancer at an early stage or prevent cancer from occurring.
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Affiliation(s)
- Stephanie R Hicks
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado.
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Amanda K Cozart
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Gary A Bellus
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
| | - Kami W Schneider
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, Colorado
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado, Aurora, Colorado
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3
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Abstract
OBJECTIVE. Loss of the neurofibromatosis type 1 (NF1) tumor suppressor protein causes uninhibited activation of the RAS oncogene, which leads to tumorigenesis in patients with NF1. This case-based review discusses imaging manifestations of NF1 in the abdomen and pelvis, highlighting key genetic associations and management to elucidate features different from the general population. CONCLUSION. The spectrum of pathologic findings includes gastrointestinal tumors such as gastrointestinal stromal tumors, genitourinary lesions including urogenital neurofibromas, vascular entities such as renal artery stenosis, and less common associations like lymphoma.
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Significantly greater prevalence of DICER1 alterations in uterine embryonal rhabdomyosarcoma compared to adenosarcoma. Mod Pathol 2020; 33:1207-1219. [PMID: 31900434 DOI: 10.1038/s41379-019-0436-0] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 11/06/2019] [Accepted: 11/25/2019] [Indexed: 01/25/2023]
Abstract
Embryonal rhabdomyosarcomas (ERMS) account for 2-3% of cancers in pediatric and adolescent populations. They are rarer in adults. We and others have reported that ERMS arising in the uterine cervix may harbor mutations in the gene encoding the microRNA biogenesis enzyme, DICER1, but a large series of cases has not been published. In the uterus, distinguishing ERMS from adenosarcoma can be very challenging, even for expert pathologists, and DICER1 alterations have been identified in a variable subset of uterine adenosarcomas. We hypothesized that DICER1 genetic testing may be useful in distinguishing between ERMS and adenosarcoma. We conducted a central pathology review-based study of 64 tumors initially thought to be uterine ERMS or adenosarcoma; 19 neoplasms had a consensus diagnosis of ERMS, 27 of adenosarcoma and for 18, no consensus diagnosis was reached. The median age at diagnosis was 30 years (range 2.5-69) for ERMS, 57.5 years (range 27-82) for adenosarcoma, and 65.5 years (range 32-86) for no consensus cases. In our series, the DICER1 mutation prevalence differed between the three groups: DICER1 alterations were present in 18/19 (95%) ERMS, 7/27 (26%) adenosarcomas (p < 0.001), and 4/18 (22%) no consensus cases. A germline alteration was present in 6/12 ERMS patients tested versus 0/6 adenosarcoma patients. Thus, although DICER1 mutations are near ubiquitous in uterine ERMS and are significantly less common in uterine adenosarcoma, DICER1 testing is only of value in distinguishing between the two neoplasms when a DICER1 mutation is absent, as this is helpful in excluding ERMS. On review of the clinical and radiological features of the single DICER1 wild-type cervical ERMS, this was thought most likely to be of vaginal origin. Given the significant prevalence of DICER1 germline pathogenic variants in uterine ERMS, all patients with this diagnosis should be referred to a genetics service.
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The association of Neurofibromatosis Type 1 and lower urinary tract dysfunction in the paediatric population - A critical review of literature. J Pediatr Urol 2020; 16:357-365. [PMID: 32467024 DOI: 10.1016/j.jpurol.2020.04.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/07/2020] [Accepted: 04/21/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Neurofibromatosis Type 1 (NF1) is an autosomal dominant, multisystem, neurocutaneous disorder. This condition has been associated with lower urinary tract dysfunction due to either direct genitourinary organ involvement or spinal cord compression. Based on current literature, there are no reviews examining the relationship between NF1 and lower urinary tract dysfunction (LUTD) in the paediatric population. METHODS A critical review of the literature was conducted using a systematic search of MEDLINE, PubMed and Embase yielding a total of 1285 manuscripts published up to 2019. Two independent reviewers selected studies for screening, eligibility and inclusion into the review. Following title, abstract and full-text review, 46 articles were analyzed. RESULTS Within these 46 articles, 79 cases were presented. The mean patient age at the time of presentation was 6.97 ± 9.19 years. The most common urologic presentations were irritative lower urinary tract symptoms (30%) and a newly discovered abdominopelvic mass (21%). Diagnostic investigations commonly demonstrated a retrovesical mass with direct invasion of the bladder in 58 cases (73%) and other genitourinary organ involvement in 39 cases (39%). Throughout the total case volume, LUTD was present in 49%. Pathology of malignancy was most commonly malignant peripheral nerve sheath tumour and rhabdomyosarcoma (20% and 14%, respectively). When indicated, surgical management of the lower urinary tract included both radical and partial cystectomy. Conservative management of urinary retention included clean intermittent catheterization (56%), suprapubic catheterization (22%), vesicostomy creation (11%) and mitrofanoff creation (11%). CONCLUSION A complete urologic evaluation including clinical, radiologic, and possibly pathologic investigation is warranted and should be performed for both diagnosis and appropriate management of LUTD in patients with NF1.
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Abstract
Different types of malignancies can be seen in patients with neurofibromatosis type 1 (NF-1). Herein we present a rare combination of NF-1 and biliary rhabdomyosarcoma in a male infant. An 11-month-old boy, who was recently diagnosed with NF-1, presented to the outpatient clinic with a 3-month history of prolonged jaundice, and failure to thrive. Clinical examination showed >20 café au let spots distributed mainly over the abdominal trunk. Hepatomegaly (4 cm below the costal margin) was additionally observed. His father was diagnosed with NF-1. Radiologic imaging studies showed a 6×5×5 cm in diameter cystic mass with multiple septations in the segment 4A of the liver. Surgical excision of the left hepatic lobe followed by hepatojejunostomy was further performed. Histopathology examination showed embryonal type rhabdomyosarcoma originating from the biliary duct. Chemotherapy regimen consisting of cyclophosphamide, actinomycin D, and vincristine, and radiotherapy were then initiated. This treatment led to a significant improvement in the patient's clinical status, and radiologic finding portrayed attainment of complete resolution. He is still in complete remission without any sequelae for 8 years.
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Terzi YK, Oğuzkan-Balcı S, Anlar B, Varan A, Ersoy-Evans S, Sharafi P, Ayter Ş. Clinical findings and mutation analysis of NF1 patients in Turkey. Meta Gene 2018. [DOI: 10.1016/j.mgene.2017.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Porrello A, Piergentili RB. Contextualizing the Genes Altered in Bladder Neoplasms in Pediatric andTeen Patients Allows Identifying Two Main Classes of Biological ProcessesInvolved and New Potential Therapeutic Targets. Curr Genomics 2016; 17:33-61. [PMID: 27013923 PMCID: PMC4780474 DOI: 10.2174/1389202916666151014222603] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Revised: 06/29/2015] [Accepted: 07/08/2015] [Indexed: 12/19/2022] Open
Abstract
Research on bladder neoplasms in pediatric and teen patients (BNPTP) has described 21 genes, which are variously involved in this disease and are mostly responsible for deregulated cell proliferation. However, due to the limited number of publications on this subject, it is still unclear what type of relationships there are among these genes and which are the chances that, while having different molecular functions, they i) act as downstream effector genes of well-known pro- or anti- proliferative stimuli and/or interplay with biochemical pathways having oncological relevance or ii) are specific and, possibly, early biomarkers of these pathologies. A Gene Ontology (GO)-based analysis showed that these 21 genes are involved in biological processes, which can be split into two main classes: cell regulation-based and differentiation/development-based. In order to understand the involvement/overlapping with main cancer-related pathways, we performed a meta-analysis dependent on the 189 oncogenic signatures of the Molecular Signatures Database (OSMSD) curated by the Broad Institute. We generated a binary matrix with 53 gene signatures having at least one hit; this analysis i) suggests that some genes of the original list show inconsistencies and might need to be experimentally re- assessed or evaluated as biomarkers (in particular, ACTA2) and ii) allows hypothesizing that important (proto)oncogenes (E2F3, ERBB2/HER2, CCND1, WNT1, and YAP1) and (putative) tumor suppressors (BRCA1, RBBP8/CTIP, and RB1-RBL2/p130) may participate in the onset of this disease or worsen the observed phenotype, thus expanding the list of possible molecular targets for the treatment of BNPTP.
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Affiliation(s)
- A. Porrello
- Comprehensive Cancer Center (LCCC), University of North Carolina (UNC)-Chapel Hill, Chapel Hill, 27599 NC, USA
| | - R. b Piergentili
- Institute of Molecular Biology and Pathology at CNR (CNR-IBPM); Department of Biology and Biotechnologies, Sapienza – Università di Roma, Italy
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Zangari A, Zaini J, Gulìa C. Genetics of Bladder Malignant Tumors in Childhood. Curr Genomics 2016; 17:14-32. [PMID: 27013922 PMCID: PMC4780472 DOI: 10.2174/1389202916666151014221954] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Revised: 05/25/2015] [Accepted: 06/30/2015] [Indexed: 12/30/2022] Open
Abstract
Bladder masses are represented by either benign or malignant entities. Malignant bladder tumors are frequent causes of disease and death in western countries. However, in children they are less common. Additionally, different features are found in childhood, in which non epithelial tumors are more common than epithelial ones. Rhabdomyosarcoma is the most common pediatric bladder tumor, but many other types of lesions may be found, such as malignant rhabdoid tumor (MRT), inflammatory myofibroblastic tumor and neuroblastoma. Other rarer tumors described in literature include urothelial carcinoma and other epithelial neoplasms. Rhabdomyosarcoma is associated to a variety of genetic syndromes and many genes are involved in tumor development. PAX3-FKHR and PAX7-FKHR (P-F) fusion state has important implications in the pathogenesis and biology of RMS, and different genes alterations are involved in the pathogenesis of P-F negative and embryonal RMS, which are the subsets of tumors most frequently affecting the bladder. These genes include p53, MEF2, MYOG, Ptch1, Gli1, Gli3, Myf5, MyoD1, NF1, NRAS, KRAS, HRAS, FGFR4, PIK3CA, CTNNB1, FBXW7, IGF1R, PDGFRA, ERBB2/4, MET, BCOR. Malignant rhabdoid tumor (MRT) usually shows SMARCB1/INI1 alterations. Anaplastic lymphoma kinase (ALK) gene translocations are the most frequently associated alterations in inflammatory myofibroblastic tumor (IMT). Few genes alterations in urothelial neoplasms have been reported in the paediatric population, which are mainly related to deletion of p16/lnk4, overexpression of CK20 and overexpression of p53. Here, we reviewed available literature to identify genes associated to bladder malignancies in children and discussed their possible relationships with these tumors.
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Affiliation(s)
| | - Johan Zaini
- Università degli Studi della Tuscia, dipartimento di scienze biologiche (DEB), Viterbo, Italy
| | - Caterina Gulìa
- Università degli Studi di Roma La Sapienza, Dipartimento di Urologia, Roma, Italy
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10
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[Mesenchymal tumors of the urinary bladder]. DER PATHOLOGE 2016; 37:61-70. [PMID: 26746411 DOI: 10.1007/s00292-015-0122-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mesenchymal tumors and tumor-like lesions of the urinary bladder are rare. They encompass a heterogeneous group of reactive pseudosarcomatous tumor-like changes and benign neoplastic lesions as well as malignant neoplasms (sarcomas) with variable biological behavior. The well-known differential diagnostic difficulties related to these conditions are mainly due to their rarity and thus limited experience and familiarity with their histological features and due to the significant morphological overlap between fully benign reactive conditions and aggressive malignant neoplasms. The distinction between them may on occasion represent a real challenge and is associated with several pitfalls. This overview summarizes the clinicopathological and differential diagnostic aspects of the most important lesions and discuss their differential diagnosis in the light of current knowledge.
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Crucis A, Richer W, Brugières L, Bergeron C, Marie-Cardine A, Stephan JL, Girard P, Corradini N, Munzer M, Lacour B, Minard-Colin V, Sarnacki S, Ranchere-Vince D, Orbach D, Bourdeaut F. Rhabdomyosarcomas in children with neurofibromatosis type I: A national historical cohort. Pediatr Blood Cancer 2015; 62:1733-8. [PMID: 25893277 DOI: 10.1002/pbc.25556] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 03/20/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) occasionally occurs in a context of a predisposition syndrome. The most common predisposition syndromes include germline TP53 mutations and constitutive alterations in RAS pathway activation, such as Costello syndrome, Noonan syndrome and neurofibromatosis type 1. We report a national retrospective series of 16 RMS occurring in neurofibromatosis type 1 (NF1) patients during childhood, within a 20-year period. RESULTS The mean age at diagnosis of the cancer was 2.5 years. All were embryonal subtype. Most tumours developed in the pelvis. One was metastatic. Chemotherapy and radiotherapy were normally scheduled without any specific toxicity. The 5-year event-free survival and overall survival were 67% and 87%, respectively. Long-term sequel related to chemotherapy consisted in two chronic tubulopathies, hence not obviously different from non-NF1 patients. No second cancer was reported so far with a median follow-up of 9.7 years. The genomic analysis performed on six samples revealed the abnormalities commonly observed in sporadic RMS: gain of chromosome 2 (5/6), 8 (6/6) and chromosome 11p loss of heterozygosity (5/6). Interestingly, we identified small deletions in tumour suppressor genes that may synergize with NF1 inactivation. CONCLUSIONS Patients with neurofibromatosis are prone to develop embryonal-type RMS that require the same treatment as sporadic cases.
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Affiliation(s)
- Anne Crucis
- Hopital Necker Enfants-Malades, Service de Reanimation pédiatrique, Paris, France
| | - Wilfrid Richer
- INSERMU830, Laboratoire de génétique et biologie des cancers, Institut Curie, Paris, France.,SIRIC, Recherche Translationnelle en Oncologie Pediatrique, Institut Curie, Paris, France
| | - Laurence Brugières
- Département d'Oncologie de l'Enfant et l'Adolescent, Institut Gustave Roussy, Villejuif, France
| | | | | | - Jean-Louis Stephan
- CHU de Saint-Etienne, Service d'hémato-oncologie pédiatrique, Saint-Etienne, France.,Universite Saint-Etienne, Saint-Etienne, France
| | - Pauline Girard
- CHU de Grenoble, Service d'hémato-oncologie pédiatrique, Grenoble, France
| | - Nadege Corradini
- CHU d'Amiens, Service d'hémato-oncologie pédiatrique, Amiens, France
| | - Martine Munzer
- CHU de Nantes, Service d'hémato-oncologie pédiatrique, Nantes, France
| | - Brigitte Lacour
- Registre national des tumeurs solides de l'enfant, CESP INSERM, Vandoeuvre-les-Nancy, France
| | - Veronique Minard-Colin
- Département d'Oncologie de l'Enfant et l'Adolescent, Institut Gustave Roussy, Villejuif, France
| | - Sabine Sarnacki
- Université Paris Rene Descartes, Paris, France.,Hopital Necker Enfants-Malades, Service de chirurgie infantile, Paris, France
| | | | - Daniel Orbach
- INSERMU830, Laboratoire de génétique et biologie des cancers, Institut Curie, Paris, France
| | - Franck Bourdeaut
- INSERMU830, Laboratoire de génétique et biologie des cancers, Institut Curie, Paris, France.,SIRIC, Recherche Translationnelle en Oncologie Pediatrique, Institut Curie, Paris, France.,Institut Curie, Departement d'oncologie pédiatrique adolescent jeune adulte, Paris, France
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Cecen E, Ince D, Uysal KM, Ozer E, Cetingoz R, Ozguven AA, Cakmakci H, Sarialioglu F, Olgun N. Soft tissue sarcomas and central nervous system tumors in children with neurofibromatosis type 1. Childs Nerv Syst 2011; 27:1885-93. [PMID: 21442270 DOI: 10.1007/s00381-011-1425-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Accepted: 03/03/2011] [Indexed: 11/30/2022]
Abstract
OBJECTS We aim to evaluate the characteristics of pediatric patients with neurofibromatosis type 1 (NF1) who developed soft tissue sarcomas (STSs) and central nervous system (CNS) tumors that have been followed up in our center. MATERIALS AND METHODS Medical records of children with NF1 were retrospectively analyzed. RESULTS There were 78 patients who met at least two diagnostic criteria for NF1. The median age of patients was 10 years (0.5-18), and M/F ratio was 1.3. The prevalance of the optic glioma was 11.5% (n = 9), and one patient with optic glioma also had cystic astrocytoma, one patient had brain stem tumor, and one patient had a CNS tumor (without histopathologic diagnosis). Seven of nine children were ≥ 7 years old at the time of the diagnosis of optic glioma. Visual impairment developed in four patients, and two of them were treated with radiotherapy solely on the basis of evidence of clinical and radiological progression of the tumors. Four patients developed STSs. Two of them had malignant peripheral nerve sheath tumors (MPNST), and the remaining two had bladder rhabdomyosarcoma. Three of the four patients with STSs died with progressive disease. CONCLUSION The clinical course of malignancy in NF1 is often different from that of similar tumor types in the general population. Careful follow-up in patients with NF1 is required to enable the early diagnosis of malignancies, and the developments of new targeted therapies are needed for improvement of the outcome for patients of this group, especially with MPNST.
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Affiliation(s)
- Emre Cecen
- Department of Pediatric Oncology, School of Medicine, Adnan Menderes University, Aydin, Turkey.
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Lott S, Lopez-Beltran A, Montironi R, MacLennan GT, Cheng L. Soft tissue tumors of the urinary bladder Part II: malignant neoplasms. Hum Pathol 2007; 38:963-977. [PMID: 17574946 DOI: 10.1016/j.humpath.2007.03.016] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2007] [Accepted: 03/20/2007] [Indexed: 02/02/2023]
Abstract
Most bladder tumors arise from the urothelium. However, there are several uncommon but significant malignant bladder lesions that must be differentiated from urothelial carcinomas and from benign lesions of the bladder. The second half of this two-part review will describe rare nonurothelial malignant tumors of the urinary bladder including leiomyosarcoma, rhabdomyosarcoma, angiosarcoma, malignant fibrous histiocytoma (undifferentiated sarcoma), primitive neuroectodermal tumor, malignant peripheral nerve sheath tumor, hemangiopericytoma, and alveolar soft-parts sarcoma. Common clinical presentations, morphologic characteristics, and immunohistochemical features are described to aid the practicing pathologist in the identification of these entities. Because the distinction between malignant and benign lesions has significant therapeutic and prognostic implications, key factors for differentiating them are presented.
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Affiliation(s)
- Sarah Lott
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Antonio Lopez-Beltran
- Department of Urology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Pathology, Cordoba University, E-14004 Cordoba, Spain
| | - Rodolfo Montironi
- Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche Region (Ancona), United Hospitals, 60020 Ancona, Italy
| | - Gregory T MacLennan
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Urology, Indiana University School of Medicine, Indianapolis, IN 46202, USA; Department of Pathology, Cordoba University, E-14004 Cordoba, Spain.
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