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Zhang AB, Zhang JY, Xue J, Wu ZC, Xu ZX, Sun LS, Li TJ. The prevalence, diagnostic accuracy and genotype-phenotype correlation of GNAS mutations in fibrous dysplasia: a meta-analysis. Front Genet 2024; 15:1377716. [PMID: 39135681 PMCID: PMC11317392 DOI: 10.3389/fgene.2024.1377716] [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: 02/05/2024] [Accepted: 05/17/2024] [Indexed: 08/15/2024] Open
Abstract
Background There is inconsistent evidence regarding the accuracy of GNAS mutations identification for the diagnosis of FD/MAS. This study was performed to estimate the prevalence and diagnostic accuracy of GNAS mutations detection and to preliminarily investigate the genotype-phenotype correlation in FD patients. Methods Five electronic databases were searched from 1995 to 2024 using search terms related to GNAS and fibrous dysplasia. Observational studies of FD patients undergoing GNAS mutation detection in FD were included. Results A total of 878 FD patients were included. The pooled prevalence of GNAS mutations in FD based on the random effects model was 74% (95% CI = 64%-83%). Regarding diagnostic accuracy, a sensitivity of 0.83 (95% CI, 0.65-0.96), specificity of 0.99 (95% CI, 0.98-1.00) and the area under the receiver operating characteristic curve of 98.38% were found. Additionally, meta-analysis and Fisher's test showed the GNAS mutation types were significantly associated with FD types (OR = 3.51, 95% CI = 1.05 to 11.72; p < 0.05). Conclusion A high detection rate of GNAS mutations occurred in FD, and its detection is reliable for diagnosing FD. Additionally, GNAS mutation type was types were significantly associated with FD type. Systematic Review Registration Identifier CRD42024553469.
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Affiliation(s)
- Ao-Bo Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Jian-Yun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Jiang Xue
- Department of Oral Pathology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
| | - Zhen-Chao Wu
- Department of Pulmonary and Critical Care Medicine, Peking University Third Hospital, Beijing, China
| | - Zhi-Xiu Xu
- Department of Oral Pathology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Li-Sha Sun
- Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
- National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology and Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Tie-Jun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology and National Center of Stomatology and National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, China
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Takeda N, Makise N, Kageyama H, Takahashi T, Katoh H, Odaka A, Oikawa M, Sugiyama T, Kawana H, Araki A, Kinoshita H, Hagiwara Y, Kamoda H, Yonemoto T, Itami M. The diagnostic utility of cytology specimen in a case of EWSR1::NFATC2 sarcoma. Virchows Arch 2024; 484:533-538. [PMID: 38483612 DOI: 10.1007/s00428-024-03784-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/26/2024] [Accepted: 03/10/2024] [Indexed: 04/17/2024]
Abstract
EWSR1::NFATC2 sarcoma, a rare round cell sarcoma constituting the majority of EWSR1::non-ETS sarcomas, has recently been defined in the latest WHO classification. To date, the cytological findings of EWSR1::NFATC2 sarcoma remain undocumented. We present the case of a 25-year-old man with a history of polyostotic fibrous dysplasia in the right leg, referred to our hospital with left thigh pain. Cytological findings included metachromasia, minimally pleomorphic round cells, and eosinophilic infiltration. There was no precursor fibrous dysplasia and the initial diagnosis was undifferentiated pleomorphic sarcoma. Following histologic review, we successfully performed immunocytochemistry and fluorescence in situ hybridization (FISH) on archival cytology specimens. The tumor cells were positive for NKX2-2, NKX3-1, and PAX7 and showed amplified 5' single signals of EWSR1 gene. Reverse transcriptase-polymerase chain reaction revealed an in-frame fusion of EWSR1 and NFATC2. This report describes the cytological features of EWSR1::NFATC2 sarcoma and highlights the diagnostic utility of archival cytology specimens.
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Affiliation(s)
- Naoki Takeda
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Naohiro Makise
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan.
| | - Hajime Kageyama
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Tsukasa Takahashi
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Hiroshi Katoh
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Akiko Odaka
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Mariko Oikawa
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Takahiro Sugiyama
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Hidetada Kawana
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | - Akinobu Araki
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
| | | | - Yoko Hagiwara
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | - Hiroto Kamoda
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | - Tsukasa Yonemoto
- Division of Orthopaedic Surgery, Chiba Cancer Center, Chiba, Japan
| | - Makiko Itami
- Division of Surgical Pathology, Chiba Cancer Center, 666-2 Nitona-Cho, Chuo-Ku, Chiba-Shi, Chiba, 260-8717, Japan
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3
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Kim HY, Shim JH, Heo CY. A Rare Skeletal Disorder, Fibrous Dysplasia: A Review of Its Pathogenesis and Therapeutic Prospects. Int J Mol Sci 2023; 24:15591. [PMID: 37958575 PMCID: PMC10650015 DOI: 10.3390/ijms242115591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/16/2023] [Accepted: 10/23/2023] [Indexed: 11/15/2023] Open
Abstract
Fibrous dysplasia (FD) is a rare, non-hereditary skeletal disorder characterized by its chronic course of non-neoplastic fibrous tissue buildup in place of healthy bone. A myriad of factors have been associated with its onset and progression. Perturbation of cell-cell signaling networks and response outputs leading to disrupted building blocks, incoherent multi-level organization, and loss of rigid structural motifs in mineralized tissues are factors that have been identified to participate in FD induction. In more recent years, novel insights into the unique biology of FD are transforming our understandings of its pathology, natural discourse of the disease, and treatment prospects. Herein, we built upon existing knowledge with recent findings to review clinical, etiologic, and histological features of FD and discussed known and potential mechanisms underlying FD manifestations. Subsequently, we ended on a note of optimism by highlighting emerging therapeutic approaches aimed at either halting or ameliorating disease progression.
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Affiliation(s)
- Ha-Young Kim
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea;
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
| | - Jung-Hee Shim
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
- Department of Research Administration Team, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea
| | - Chan-Yeong Heo
- Interdisciplinary Program in Bioengineering, Seoul National University, Seoul 08826, Republic of Korea;
- Department of Plastic and Reconstructive Surgery, College of Medicine, Seoul National University, Seoul 03080, Republic of Korea
- Department of Plastic and Reconstructive Surgery, Seoul National University Bundang Hospital, Seongnam 13620, Republic of Korea;
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4
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Bahceci DH, Grenert JP, Jordan RCK, Horvai AE. Genomic Profiling of the Craniofacial Ossifying Fibroma by Next-Generation Sequencing. Head Neck Pathol 2023; 17:722-730. [PMID: 36928741 PMCID: PMC10513971 DOI: 10.1007/s12105-022-01523-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/27/2022] [Indexed: 03/18/2023]
Abstract
BACKGROUND Ossifying fibroma (OF) of the craniofacial skeleton is a fibro-osseous lesion characterized by various patterns of bone formation in a cellular fibroblastic stroma. The molecular landscape of OF remains mostly unknown. There are a few known pathogenic abnormalities in OF, including HRPT2 mutations in conventional OF and SATB2 translocations in juvenile psammomatoid OF. On the other hand, conflicting reports exist regarding MDM2 gene amplification and chromosomal copy number alterations (CNA) in OF. METHODS Surgically removed biopsies and curettage specimens from OF patients were obtained. Clinical, radiographic, and pathologic features of tumors were reviewed. Genomic DNA was extracted from formalin-fixed, paraffin-embedded blocks of tumor tissue. Capture-based DNA next-generation sequencing targeting the coding regions 529 cancer genes and select introns was performed. RESULTS We identified 17 OF cases from 8 male and 8 female patients with mean age of 22 years (range 1-58 years). Nine case occurred in the gnathic bones and 8 in the extragnathic craniofacial bones. These cases included 3 juvenile psammomatoid OF, 6 conventional OF and 8 juvenile trabecular OF. Large-scale CNAs were present in 6 of 17 cases. Seven cases (41%) had focal amplifications including FOSB (n = 2, 11%), FOS (n = 4, 23%), COL1A1 (n = 4, 23%) and TBX3 (n = 5, 29%). Three cases (17%) had pathogenic CDC73 mutations. No cases showed focal MDM2 amplification. CONCLUSIONS Here, we provided a comprehensive molecular characterization of OF that reveals a heterogeneous genetic profile with occasional large-scale CNAs (n = 6, 35%). FOS, FOSB, and TBX3 genes that regulate AP-1 transcriptional complex are frequently altered in OF (n = 7, 41%), chiefly in juvenile trabecular OF. These genes encode transcription factors that act as downstream effectors of the MAP kinase signaling pathway. MDM2 amplification is an exceedingly rare event in OF, if present at all, so identification of this event should continue to raise concern for low-grade gnathic osteosarcoma. In summary, our findings suggest that OF represents a heterogeneous group of tumors at the genetic level but dysregulation of the AP-1 pathway may play a role in pathogenesis of juvenile trabecular OF.
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Affiliation(s)
- Dorukhan H Bahceci
- Department of Pathology, University of California at San Francisco, San Francisco, CA, 94143, USA
| | - James P Grenert
- Department of Pathology, University of California at San Francisco, San Francisco, CA, 94143, USA
| | - Richard C K Jordan
- Department of Pathology, University of California at San Francisco, San Francisco, CA, 94143, USA
| | - Andrew E Horvai
- Department of Pathology, University of California at San Francisco, 1825 4Th Street, Room M2354, San Francisco, CA, 94158, USA.
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5
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Alodaini AA, Abusultan A, Altarooti NA, Aldossari A, Hegazi TM, Alomran AK, Awadalla AS. A case of neonatal osteofibrous dysplasia with novel CDK12 and DDR2 mutations. Bone Rep 2023; 18:101666. [PMID: 36875508 PMCID: PMC9982453 DOI: 10.1016/j.bonr.2023.101666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/20/2023] [Accepted: 02/21/2023] [Indexed: 02/25/2023] Open
Abstract
Osteofibrous dysplasia [OFD] is a rare, benign pediatric fibro-osseous lesion that exclusively arises in the lower limbs. Apart from the limited number of familial OFD cases with MET mutation, no other genetic aberrations have been identified. Herein, we report a case of OFD in a four-month- old girl's leg with novel cyclin-dependent kinase 12 and discoidin domain receptor 2 gene mutations. Further studies to understand their role in the pathogenesis and clinical utility are needed.
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Affiliation(s)
- Amal A Alodaini
- Pathology Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
| | - Ammar Abusultan
- Orthopedic surgery Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
| | - Noor A Altarooti
- Orthopedic surgery Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
| | - Asma Aldossari
- Orthopedic surgery Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
| | - Tarek M Hegazi
- Diagnostic Radiology Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
| | - Ammar K Alomran
- Orthopedic surgery Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
| | - Awadia S Awadalla
- Pathology Department, King Fahd University Hospital, Imam Abdulrahman Bin Faisal University, 31441 Dammam, P.O. Box 1982, Kingdom of Saudi Arabia
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6
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Fukuchi M, Igarashi H, Suzuki S, Konno Y, Takano H, Fukuda M. Fibrous dysplasia of the zygomatic bone and mandibular coronoid process: A case report. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2023. [DOI: 10.1016/j.ajoms.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
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7
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Xue J, Jia K, Li T, Zhang J, An J. GNAS mutation analysis assists in differentiating chronic diffuse sclerosing osteomyelitis from fibrous dysplasia in the jaw. Mod Pathol 2022; 35:1334-1340. [PMID: 35672467 DOI: 10.1038/s41379-022-01103-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 04/23/2022] [Accepted: 05/03/2022] [Indexed: 11/10/2022]
Abstract
Chronic diffuse sclerosing osteomyelitis of the mandible (DSOM) and fibrous dysplasia (FD) are distinct lesions with overlapping clinicopathological features that complicate their diagnosis. This study aimed to evaluate the efficacy of GNAS mutation analysis in differentiating between these two conditions. DNA samples from patients with DSOM (n = 35) and FD (n = 29) were collected to analyze the presence of GNAS mutations in exons 8 and 9, the two previously reported hotspot regions, using polymerase chain reaction and direct sequencing. Twenty-four of 29 patients (83%) with FD showed missense mutations in codon 201 in exon 8, whereas no mutation was detected in exon 9. No mutations were found in any of the 35 cases with DSOM. We also identified one case with an uncertain diagnosis due to overlapping clinicopathological features of DSOM and FD. A Q227H mutation was detected in this case, that confirmed the diagnosis of FD. Taken together, the findings indicate that mutational analysis of the GNAS is a reliable approach to differentiate between DSOM and FD of the jaw.
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Affiliation(s)
- Jiang Xue
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, 22 South Avenue Zhongguancun, Haidian District, Beijing, 100081, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, PR China
| | - Kuankuan Jia
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China.,Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Avenue Zhongguancun, Haidian District, Beijing, 100081, PR China
| | - Tiejun Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, 22 South Avenue Zhongguancun, Haidian District, Beijing, 100081, PR China.,National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China.,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, PR China
| | - Jianyun Zhang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology, 22 South Avenue Zhongguancun, Haidian District, Beijing, 100081, PR China. .,National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China. .,Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences (2019RU034), Beijing, 100081, PR China.
| | - Jingang An
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing, PR China. .,Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Avenue Zhongguancun, Haidian District, Beijing, 100081, PR China.
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8
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Osteosarcoma Arising in Fibrous Dysplasia of the Long Bone: Characteristic Images and Molecular Profiles. Diagnostics (Basel) 2022; 12:diagnostics12071622. [PMID: 35885527 PMCID: PMC9323252 DOI: 10.3390/diagnostics12071622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 06/24/2022] [Accepted: 07/01/2022] [Indexed: 11/24/2022] Open
Abstract
Fibrous dysplasia (FD) is a benign fibro-osseous lesion that frequently involves the craniofacial bones and femur. Malignant transformation of FD is a rare occurrence. We report a 38-year-old woman with osteosarcoma (OS) arising from FD of the femur. Magnetic resonance imaging revealed a well-defined lesion in the medulla of the femur, with cortical thinning and local bone destruction. Wide excision of the femur was performed. Grossly, the inner part of the mass was hard and tan-gray in color, and the outer part of the mass adjacent to the cortex showed myxoid discoloration with infiltrative borders. Microscopically, most of the tumor consisted of curvilinear woven bone and fibrous stroma with bland spindle cells, which transitioned to the outer portion of the tumor, showing cellular proliferation of pleomorphic cells with frequent mitotic activity. Next-generation sequencing revealed GNAS and TP53 mutations, and the diagnosis of OS arising from FD was strongly supported. This case highlights the characteristic images and molecular features of the malignant transformation of FD.
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9
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Les lésions ostéoformatrices et les réarrangements des gènes FOS. Ann Pathol 2022; 42:208-213. [DOI: 10.1016/j.annpat.2022.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 01/07/2022] [Accepted: 01/07/2022] [Indexed: 11/18/2022]
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Miquelestorena-Standley E, Tallegas M, Bouvier C, Larousserie F, Aubert S, Gomez-Brouchet A, Guinebretière JM, Le Loarer F, Galant C, de Pinieux G. [From an optimal management of bone tissue samples to a quality patients' care in 2022 : A new paradigm]. Ann Pathol 2022; 42:202-207. [PMID: 35093248 DOI: 10.1016/j.annpat.2022.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Bone tissue can be involved by primitive or metastatic tumors and requires a specific processing both at the department of pathology and during multidisciplinary meetings. The development of fine-needle percutaneous biopsies and of molecular techniques in bone tumor pathology requires a specific management. Moreover, decalcification of samples is crucial but can be deleterious if not controlled or not appropriate. The aim of this review is to provide recommendations for management and decalcification of bone tumor samples.
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Affiliation(s)
- Elodie Miquelestorena-Standley
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France; Faculté de médecine, Université de Tours, 10, boulevard Tonnellé, 37000 Tours, France.
| | - Matthias Tallegas
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France; Plateforme de génétique moléculaire des cancers, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France
| | - Corinne Bouvier
- Service d'anatomie et cytologie pathologiques, CHU de Marseille La Timone, 264, rue Saint-Pierre, 13005 Marseille, France
| | - Frédérique Larousserie
- Service d'anatomie et cytologie pathologiques, Hôpital Cochin, 27, rue du Faubourg Saint-Jacques, 75014 Paris, France
| | - Sébastien Aubert
- Service d'anatomie et cytologie pathologiques, CHU de Lille, 2, avenue Oscar Lambret, 59000 Lille, France
| | - Anne Gomez-Brouchet
- CRB Cancer IUCT-oncopole, 1, avenue Irène Joliot-Curie, 31100 Toulouse, France
| | - Jean-Marc Guinebretière
- Service d'anatomie et cytologie pathologiques, Hôpital Curie, 26, rue d'Ulm, 75005 Paris, France
| | - François Le Loarer
- Service d'anatomie pathologique, Institut Bergonié, 229, cours Argonne, 33000 Bordeaux, France
| | - Christine Galant
- Service d'anatomie et cytologie pathologiques, Cliniques Universitaires Saint-Luc, 10, avenue Hippocrate, 1200 Bruxelles, Belgique
| | - Gonzague de Pinieux
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, hôpital Trousseau, avenue de la République, 37170 Chambray-les-Tours, France; Faculté de médecine, Université de Tours, 10, boulevard Tonnellé, 37000 Tours, France
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11
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Pick E, Schäfer T, Al-Haj Husain A, Rupp NJ, Hingsammer L, Valdec S. Clinical, Radiological, and Pathological Diagnosis of Fibro-Osseous Lesions of the Oral and Maxillofacial Region: A Retrospective Study. Diagnostics (Basel) 2022; 12:diagnostics12020238. [PMID: 35204329 PMCID: PMC8870765 DOI: 10.3390/diagnostics12020238] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 12/30/2021] [Accepted: 01/17/2022] [Indexed: 12/27/2022] Open
Abstract
Background: Fibro-osseous lesions (FOL) of the jaw represent a rare, benign group of lesions that share similar clinical, radiological, and histopathological features and are characterized by progressive, variable replacement of healthy bone tissue by fibrous connective tissue. Methods: This retrospective study aimed to evaluate the incidence of fibro-osseous lesions and to reassess the efficacy of case-specific treatment management from a clinical, radiological, and histopathological perspective based on 14 years of data. Results: Forty-four patients with a radiological and/or histopathological diagnosis of benign FOLs were identified and re-evaluated. Cemento-osseous dysplasia was the most common group of FOLs present in our patient cohort (45%), followed by ossifying fibroma (39%) and fibrous dysplasia (16%). The diagnostic imaging technique of choice was CBCT (68%), followed by PAN (18%), with most patients (95 %) additionally undergoing biopsy. The mean age of the patients at the time of diagnosis was 40.54 ± 13.7 years, with most lesions being located in the mandible (86%), with females being predominantly affected (73%). Conclusion: An interdisciplinary approach that analyzes all case-specific factors, including demographic data, medical history, intraoperative findings, and, most importantly, histopathological and radiological features, is essential for an accurate diagnosis and key to avoiding inappropriate treatment.
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Affiliation(s)
- Ellen Pick
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
| | - Tobias Schäfer
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
| | - Adib Al-Haj Husain
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
| | - Niels J. Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland;
| | - Lukas Hingsammer
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland; (E.P.); (T.S.); (A.A.-H.H.)
- Department of Stomatology, Division of Periodontology, Dental School, University of São Paulo, Butantã 2227, SP, Brazil
- Correspondence: ; Tel.: +41-44-634-32-90
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12
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de Pinieux G. 2012–2022 : dix années d’importantes avancées en pathologie tumorale ostéo-articulaire. Ann Pathol 2022; 42:199-201. [DOI: 10.1016/j.annpat.2021.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/09/2021] [Indexed: 11/28/2022]
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Shi R, Li X, Zhang J, Chen F, Ma M, Feng Y, Li T. Clinicopathological and genetic study of a rare occurrence: Malignant transformation of fibrous dysplasia of the jaws. Mol Genet Genomic Med 2022; 10:e1861. [PMID: 34989160 PMCID: PMC8801143 DOI: 10.1002/mgg3.1861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 11/01/2021] [Accepted: 12/14/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Malignant transformation of fibrous dysplasia (FD) is very rare and little is known about this occurrence. METHODS We present the detailed clinical course of three cases of osteosarcoma arising from FD of the jaws and explore the genetic aberrations by Sanger sequencing, whole-exome sequencing (WES) and immunohistochemistry (IHC). A literature review of important topics related to this occurrence was also performed. RESULTS It was observed that patients with secondary sarcoma from FD showed a wide range of ages, with most during the third decade. Female and males were equally affected. Craniofacial bones and femurs were the most affected sites. High-risk factors for this occurrence included polyostotic FD, McCune-Albright syndrome and excess growth hormone. Notably, a potential relationship between thyroid hormones and sarcoma development was suggested in one patient, who began to show malignant features after hypothyroidism correction. Sanger sequencing revealed GNAS mutations of FD retained in all malignant tissues. Additionally, abnormal TP53 was demonstrated in all three cases by WES and IHC. WES also revealed two other driver mutations, ROS1 and CHD8, and large amounts of somatic copy number alterations (CNAs) where various oncogenes and tumour suppressors are located. CONCLUSION This study demonstrated and reviewed the clinical features and risk factors for a rare occurrence, secondary sarcoma from FD, and provided important new knowledge about its genetics.
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Affiliation(s)
- Ruirui Shi
- Central LaboratoryPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial RegionsChinese Academy of Medical Sciences (2019RU034)BeijingChina
| | - Xuefen Li
- Central LaboratoryPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial RegionsChinese Academy of Medical Sciences (2019RU034)BeijingChina
| | - Jianyun Zhang
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial RegionsChinese Academy of Medical Sciences (2019RU034)BeijingChina
- Department of Oral PathologyPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
| | - Feng Chen
- Central LaboratoryPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
| | - Ming Ma
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial RegionsChinese Academy of Medical Sciences (2019RU034)BeijingChina
- Department of Oral PathologyPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
| | - Yanrui Feng
- Central LaboratoryPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
| | - Tiejun Li
- Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial RegionsChinese Academy of Medical Sciences (2019RU034)BeijingChina
- Department of Oral PathologyPeking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental MaterialsBeijingPR China
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14
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Persichetti A, Milanetti E, Palmisano B, di Filippo A, Spica E, Donsante S, Coletta I, Venti MDS, Ippolito E, Corsi A, Riminucci M, Raimondo D. Nanostring technology on Fibrous Dysplasia bone biopsies. A pilot study suggesting different histology-related molecular profiles. Bone Rep 2021; 16:101156. [PMID: 34950753 PMCID: PMC8671863 DOI: 10.1016/j.bonr.2021.101156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 12/02/2022] Open
Abstract
Identifying the molecular networks that underlie Fibrous Dysplasia (FD) is key to understand the pathogenesis of the disease, to refine current diagnostic approaches and to develop efficacious therapies. In this study, we used the NanoString nCounter Analysis System to investigate the gene signature of a series of nine Formalin Fixed Decalcified and Paraffin-Embedded (FFDPE) bone biopsies from seven FD patients. We analyzed the expression level of 770 genes. Unsupervised clustering analysis demonstrated partitioning into two clusters with distinct patterns of gene expression. Differentially expressed genes included growth factors, components of the Wnt signaling system, interleukins and some of their cognate receptors, ephrin ligands, matrix metalloproteinases, neurotrophins and genes encoding components of the cAMP-dependent protein kinase. Interestingly, two tissue samples obtained from the same skeletal site of one patient one year apart failed to segregate in the same cluster. Retrospective histological review of the samples revealed different microscopic aspects in the two groups. The results of our pilot study suggest that the genetic signature of FD is heterogeneous and varies according to the histology and, likely, to the age of the lesion. In addition, they show that the Nanostring technology is a valuable tool for molecular translational studies on archival FFDPE material in FD and other rare bone diseases. We used the NanoString technology to analyze Formalin Fixed Decalcified Paraffin Embedded (FFDPE) Fibrous Dysplasia samples. We show that Fibrous Dysplasia lesions may have different molecular profiles consistent with its histological heterogeneity. NanoString technology is a valuable tool for molecular studies on rare bone diseases by using FFDPE archival material.
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Affiliation(s)
- Agnese Persichetti
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | - Edoardo Milanetti
- Department of Physics, Piazzale Aldo Moro 5, 00185 Rome, Italy.,Center for Life Nano Science@Sapienza, Italian Institute of Technology, Viale Regina Elena 291, 00161 Rome, Italy
| | - Biagio Palmisano
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | | | - Emanuela Spica
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | - Samantha Donsante
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | - Ilenia Coletta
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | | | - Ernesto Ippolito
- Department of Orthopaedic Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Alessandro Corsi
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | - Mara Riminucci
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
| | - Domenico Raimondo
- Department of Molecular Medicine, Viale Regina Elena, 324, 00161 Rome, Italy
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15
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Nascimento AF, Kilpatrick SE, Reith JD. Osteofibrous Dysplasia and Adamantinoma. Surg Pathol Clin 2021; 14:723-735. [PMID: 34742490 DOI: 10.1016/j.path.2021.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
For decades, the diagnosis, treatment, and even pathogenesis of the osteofibrous dysplasia/osteofibrous dysplasia-like adamantinoma/classic adamantinoma spectrum of neoplasms have been controversial. Herein, we discuss and illustrate the radiographic and histologic spectrum, differential diagnoses, unifying chromosomal and molecular abnormalities, and current controversies and treatment recommendations for each entity.
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Affiliation(s)
- Alessandra F Nascimento
- Department of Pathology, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA
| | - Scott E Kilpatrick
- Department of Pathology, L25, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA
| | - John D Reith
- Department of Pathology, L25, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
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16
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Toferer A, Truschnegg A, Kashofer K, Beham-Schmid C, Beham A. First presentation of a frameshift mutation in the SETD2 gene of a juvenile psammomatoid ossifying fibroma (JPOF) associated with an aneurysmal bone cyst. Diagn Pathol 2021; 16:91. [PMID: 34657606 PMCID: PMC8520634 DOI: 10.1186/s13000-021-01160-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/27/2021] [Indexed: 11/19/2022] Open
Abstract
Background The rarity of juvenile psammomatoid ossifying fibroma (JPOF) and lack of cytogenetic studies prompted us to report a novel SETD2 gene mutation in a benign odontogenic tumour. Case presentation A 21-year-old man presented with a hard, expanded mandibular cortex. Computed tomography revealed multilocular radiopacity in the mandible; this was reconstructed via segmental mandibulectomy using a vascularised iliac crest flap. Based on the clinical and histological findings, we diagnosed JPOF associated with an aneurysmal bone cyst. Microscopically, the solid area was characterised by many rounded or angular ossicles in a cellular fibrous stroma. The stromal cells were spindle-like or stellate. Next-generation sequencing detected a frame shift mutation of the SETD2 gene, while the copy number was normal. Conclusions Our findings suggest further genetic studies should be performed to assess whether this mutation is related to tumour genesis.
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Affiliation(s)
- A Toferer
- Division of Oral and Maxillofacial Surgery, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.
| | - A Truschnegg
- Division of Dental Medicine and Oral Health, Medical University of Graz, Graz, Austria
| | - K Kashofer
- Diagnostic and Research Center for Molecular BioMedicine, Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - C Beham-Schmid
- Diagnostic and Research Center for Molecular BioMedicine, Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - A Beham
- Medical University of Graz, Neue Stiftingtalstraße 6, 8036, Graz, Austria
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17
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Günhan Ö, Kahraman D, Yalçın ÜK. The possible pathogenesis of cemento-osseous dysplasia: A case series and discussion. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2021. [DOI: 10.1016/j.adoms.2021.100105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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18
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Copy number alteration profiling facilitates differential diagnosis between ossifying fibroma and fibrous dysplasia of the jaws. Int J Oral Sci 2021; 13:21. [PMID: 34188021 PMCID: PMC8242074 DOI: 10.1038/s41368-021-00127-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/19/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022] Open
Abstract
Ossifying fibroma (OF) and fibrous dysplasia (FD) are two fibro-osseous lesions with overlapping clinicopathological features, making diagnosis challenging. In this study, we applied a whole-genome shallow sequencing approach to facilitate differential diagnosis via precise profiling of copy number alterations (CNAs) using minute amounts of DNA extracted from morphologically correlated microdissected tissue samples. Freshly frozen tissue specimens from OF (n = 29) and FD (n = 28) patients were obtained for analysis. Lesion fibrous tissues and surrounding normal tissues were obtained by laser capture microdissection (LCM), with ~30–50 cells (5 000–10 000 µm2) per sample. We found that the rate of recurrent CNAs in OF cases was much higher (44.8%, 13 of 29) than that in FD cases (3.6%, 1 of 28). Sixty-nine percent (9 of 13) of the CNA-containing OF cases involved segmental amplifications and deletions on Chrs 7 and 12. We also identified eight CNA-associated genes (HILPDA, CALD1, C1GALT1, MICALL2, PHF14, AIMP2, MDM2, and CDK4) with amplified expression, which was consistent with the copy number changes. We further confirmed a jaw lesion with a previous uncertain diagnosis due to its ambiguous morphological features and the absence of GNAS mutation as OF based on the typical Chr 12 amplification pattern in its CNA profile. Moreover, analysis of a set of longitudinal samples collected from an individual with a cellular lesion in suspicion of OF at the first surgery, recurrence and the latest malignant transformation revealed identical CNA patterns at the three time points, suggesting that copy number profiling can be used as an important tool to identify borderline lesions or lesions with malignant potential. Overall, CNA profiling of fibro-osseous lesions can greatly improve differential diagnosis between OF and FD and help predict disease progression.
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19
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Anastasiadis K, Lambropoulos V, Tsoleka K, Kepertis C, Mouravas V, Spyridakis I. Frontal bone fibrous dysplasia in a 6-months-old boy: A distinctive entity. LA PEDIATRIA MEDICA E CHIRURGICA 2021; 43. [PMID: 33739058 DOI: 10.4081/pmc.2021.225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 03/02/2021] [Indexed: 11/23/2022] Open
Abstract
Fibrous Dysplasia (FD) is a non-malignant condition caused by post-zygotic, activating mutations of the GNAS gene that results in inhibition of the differentiation and proliferation of bone-forming stromal cells and leads to the replacement of normal bone and marrow by fibrous tissue and woven bone. The clinical behavior and progression of FD is variable. The management of this condition is difficult and in every case is strictly individualized. We report a case of frontal fibrous dysplasia in a 6month's old boy who underwent a successfully resection of the lesion with an excellent cosmetic effect.
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Affiliation(s)
- Kleanthis Anastasiadis
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki.
| | - Vassilis Lambropoulos
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki.
| | - Kalliopi Tsoleka
- Neurosurgeon,Chief of the Neurosurgery Department, General Hospital "Papageorgiou", Thessaloniki.
| | - Chrysostomos Kepertis
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki.
| | - Vassilis Mouravas
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki.
| | - Ioannis Spyridakis
- 2nd Department of Pediatric Surgery, Aristotle University of Thessaloniki, General Hospital "Papageorgiou", Thessaloniki.
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20
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Yap FHX, Amanuel B, Van Vliet C, Thomas M, Wong D. Malignant transformation of fibrous dysplasia into osteosarcoma confirmed with TP53 somatic mutation and mutational analysis of GNAS gene. Pathology 2020; 53:652-654. [PMID: 33272697 DOI: 10.1016/j.pathol.2020.08.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 12/26/2022]
Affiliation(s)
- Francis H X Yap
- Department of Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia.
| | - Benhur Amanuel
- Department of Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia
| | - Chris Van Vliet
- Department of Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia
| | - Marc Thomas
- Department of Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia
| | - Daniel Wong
- Department of Anatomical Pathology, PathWest, QEII Medical Centre, Nedlands, WA, Australia; School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, WA, Australia
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21
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Okuda M, Kobayashi S, Gabata T, Yamamoto N, Nojima T. Undifferentiated Pleomorphic Sarcoma Arising in a Fibrous Dysplasia Confirmed by GNAS Mutation Analysis: A Case Report. JBJS Case Connect 2020; 10:e20.00157. [PMID: 33438968 DOI: 10.2106/jbjs.cc.20.00157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE We report the case of a 78-year-old woman with undifferentiated pleomorphic sarcoma (UPS) of the proximal femur arising in a previous site of fibrous dysplasia (i.e., a liposclerosing myxofibrous tumor) that had been treated 4 years earlier with curetted surgery. GNAS mutation was detected in both the previous benign lesion and the UPS. CONCLUSION Genetic analysis is useful in demonstrating the origin of the tumor especially in fibrous dysplasia with severe degeneration that have undergone malignant transformation.
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Affiliation(s)
- Miho Okuda
- Department of Radiology, Kanazawa University Hospital, Kanazawa, Japan
| | - Satoshi Kobayashi
- Department of Quantum Medical Technology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Toshifumi Gabata
- Department of Radiology, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Norio Yamamoto
- Department of Advanced and Innovative Musculoskeletal Medicine, Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Japan
| | - Takayuki Nojima
- Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan
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22
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Hameed M, Horvai AE, Jordan RCK. Soft Tissue Special Issue: Gnathic Fibro-Osseous Lesions and Osteosarcoma. Head Neck Pathol 2020; 14:70-82. [PMID: 31950477 PMCID: PMC7021863 DOI: 10.1007/s12105-019-01094-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 10/29/2019] [Indexed: 12/29/2022]
Abstract
Gnathic fibro-osseous lesions are a diverse group of disease processes which share overlapping microscopic features characterized by fibroblastic stroma with variable cellularity and a range of bone forming pathological processes leading to woven, sclerotic and cementum-like structures. Some of the lesions are unique to craniofacial location and a combination of clinical, radiological and pathological correlation is often necessary for diagnostic accuracy. Gnathic osteosarcomas are rare tumors with differences in age distribution and behavior as compared to osteosarcoma of long bones. This review will discuss the clinicopathological and radiological features of gnathic fibro-osseous lesions and osteosarcoma with updates on current genetics and molecular pathogenesis.
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Affiliation(s)
- Meera Hameed
- Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY 10065 USA
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23
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Corsi A, Fadda MT, Terenzi V, Valentini V, Riminucci M. Secondary desmoplastic fibroma-like tissue changes in mandibular fibrous dysplasia: clinicopathological and molecular study of a case. Br J Oral Maxillofac Surg 2019; 58:96-98. [PMID: 31563484 DOI: 10.1016/j.bjoms.2019.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 09/09/2019] [Indexed: 11/24/2022]
Abstract
Fibrous dysplasia may show locally aggressive behaviour reflecting secondary intralesional changes, extension to soft tissue, or malignant transformation. We report the case of a patient with polyostotic fibrous dysplasia who had a giant mandibular lesion consisting of histologically typical, genotypically-confirmed, fibrous dysplasia merged with a fibrotic and hypocellular desmoplastic fibroma-like tissue in which the same Gsα-R201H mutation was detected. The occurrence of the same mutation in both the fibrous dysplasia and areas of desmoplastic fibroma suggests that the fibroma-like tissue reflects an unusual secondary tissue change within an otherwise typical fibrous dysplasia. To the best of our knowledge, only four cases of fibrous dysplasia with desmoplastic fibroma-like tissue changes have been reported.
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Affiliation(s)
- A Corsi
- Department of Molecular Medicine, Sapienza University of Rome, Italy.
| | - M T Fadda
- Department of Odontostomatological Science and Maxillo-Facial Surgery, Sapienza University of Rome, Italy
| | - V Terenzi
- Department of Odontostomatological Science and Maxillo-Facial Surgery, Sapienza University of Rome, Italy
| | - V Valentini
- Department of Odontostomatological Science and Maxillo-Facial Surgery, Sapienza University of Rome, Italy
| | - M Riminucci
- Department of Molecular Medicine, Sapienza University of Rome, Italy
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24
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Traversari M, Serrangeli MC, Catalano G, Petrella E, Piciucchi S, Feletti F, Oxilia G, Cristiani E, Vazzana A, Sorrentino R, De Fanti S, Luiselli D, Calcagnile L, Saragoni L, Feeney RNM, Gruppioni G, Cilli E, Benazzi S. Multi-analytic study of a probable case of fibrous dysplasia (FD) from certosa monumental cemetery (Bologna, Italy). INTERNATIONAL JOURNAL OF PALEOPATHOLOGY 2019; 25:1-8. [PMID: 30913508 DOI: 10.1016/j.ijpp.2019.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To evaluate, via a multidisciplinary approach, a distinctive paleopathological condition believed to be fibrous dysplasia, found on a 19th/20th century skeleton from Certosa Monumental Cemetery, Bologna, Italy. MATERIALS A skeletonized cranium and mandible recovered from an ossuary in 2014. METHODS Pathological alterations were analysed by radiological examination, dental macrowear, histopathological and genetic analyses. RESULT The skeleton is believed to be an adult male. Differential diagnoses include Paget's disease, McCune-Albright syndrome, osteochondroma and osteosarcoma. The radiographic findings, along with the solitary nature of the lesions, are strong evidence for the diagnosis of fibrous dysplasia (FD). Genetic analysis further revealed a frequency of ˜1% of mutant alleles with the R201C substitution, one of the post-zygotic activating mutation frequently associated with FD. CONCLUSIONS The multi-analytical method employed suggests a diagnosis of monostotic form of FD. The diagnostic design incorporates multiple lines of evidence, including macroscopic, histopathological, and genetic analyses. SIGNIFICANCE Through the use of a multi-analytic approach, robust diagnoses can be offered. This case serves as one of the oldest examples of FD from an historical context. The genetic mutation detected, associated with FD, has not been previously reported in historical/ancient samples.
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Affiliation(s)
- Mirko Traversari
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy.
| | - Maria Cristina Serrangeli
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy; UCD School of Medicine, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Giulio Catalano
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Enrico Petrella
- Department of Radiology, AUSL Romagna, Morgagni-Pierantoni city hospital, via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Sara Piciucchi
- Department of Radiology, AUSL Romagna, Morgagni-Pierantoni city hospital, via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Francesco Feletti
- Department of Diagnostic Imaging Ausl Romagna, Santa Maria delle Croci Hospital, Viale Randi, 5, 48121 Ravenna, Italy
| | - Gregorio Oxilia
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Emanuela Cristiani
- Department of Oral and Maxillofacial Sciences, School of Dentistry, Sapienza University of Rome, Via Caserta, 6, 00161 Rome
| | - Antonino Vazzana
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Rita Sorrentino
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy; Department of Biological, Geological and Environmental Sciences, University of Bologna, via Selmi 3, Bologna, Italy
| | - Sara De Fanti
- Department of Biological, Geological and Environmental Sciences, University of Bologna, via Selmi 3, Bologna, Italy
| | - Donata Luiselli
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Lucio Calcagnile
- CEDAD - CEnter for DAting and Diagnostics Department of Mathematics and Physics "Ennio De Giorgi", University of Salento and INFN-National Institute for Nuclear Physics, Via Monteroni, 73100, Lecce, Italy
| | - Luca Saragoni
- Department of Pathological Anatomy, AUSL Romagna, Morgagni-Pierantoni city hospital, via Carlo Forlanini 34, 47121, Forlì, Italy
| | - Robin N M Feeney
- UCD School of Medicine, Health Science Centre, University College Dublin, Belfield, Dublin 4, Ireland
| | - Giorgio Gruppioni
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Elisabetta Cilli
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy
| | - Stefano Benazzi
- Department of Cultural Heritage, University of Bologna, via degli Ariani 1, 48121, Ravenna, Italy; Department of Human Evolution, Max Planck Institute for Evolutionary Anthropology, Deutscher Platz 6, 04103, Leipzig, Germany
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25
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Wagner VP, Carlos R, Romañach MJ, Lopes MA, Speight PM, Vargas PA. Malignant transformation of craniomaxillofacial fibro‐osseous lesions: A systematic review. J Oral Pathol Med 2019; 48:441-450. [DOI: 10.1111/jop.12867] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/08/2019] [Accepted: 04/29/2019] [Indexed: 12/21/2022]
Affiliation(s)
- Vivian P. Wagner
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil
| | - Roman Carlos
- Pathology Department Centro Clinico de Cabeza y Cuello Guatemala City Guatemala
| | - Mário J. Romañach
- Oral Pathology, Department of Oral Diagnosis and Pathology, School of Dentistry Federal University of Rio de Janeiro Rio de Janeiro Brazil
| | - Marcio A. Lopes
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil
| | - Paul M. Speight
- Department of Oral Pathology, School of Clinical Dentistry University of Sheffield Sheffield UK
| | - Pablo A. Vargas
- Department of Oral Diagnosis, Piracicaba Dental School University of Campinas Piracicaba São Paulo Brazil
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences University of Pretoria Pretoria South Africa
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Spontaneous osteosarcoma transformation of fibrous dysplasia in maxilla. J Dent Sci 2019; 14:219-222. [PMID: 31210897 PMCID: PMC6561902 DOI: 10.1016/j.jds.2019.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 04/22/2019] [Indexed: 11/23/2022] Open
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27
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Lam SW, van IJzendoorn DG, Cleton-Jansen AM, Szuhai K, Bovée JV. Molecular Pathology of Bone Tumors. J Mol Diagn 2019; 21:171-182. [DOI: 10.1016/j.jmoldx.2018.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/04/2018] [Accepted: 11/16/2018] [Indexed: 12/23/2022] Open
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Vescini F, Falchetti A, Tonelli V, Carpentieri M, Cipri C, Cosso R, Kara E, Triggiani V, Grimaldi F. Mazabraud's Syndrome: A Case Report and Up-To-Date Literature Review. Endocr Metab Immune Disord Drug Targets 2018; 19:885-893. [PMID: 30585553 DOI: 10.2174/1871530319666181226103700] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 10/02/2018] [Accepted: 10/04/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Mazabraud's syndrome is a rare form of bone fibrous dysplasia associated with intramuscular myxomas. Fibrous dysplasia, is generally localized to pelvis and femur and it results in a fragile bone with deformities, pain, pathological fractures and functional impairment. Intramuscular myxomas, are rare benign mesenchymal neoplasms that exceptionally may evolve to malignant forms. METHODS This case report describes a 66-year-old woman with Mazabraud's Syndrome (MS), characterized both by monostotic right femur fibrous dysplasia and by a solitary intramuscular myxoma at the right quadriceps muscle, that underwent a long-term treatment (4 years) with intravenous zoledronic acid. RESULTS Zoledronic acid therapy rapidly lowered bone pain together with a reduction of intramuscular myxoma volume, but did not affect the extension of fibrous dysplasia. No adverse effects have been observed during treatment. CONCLUSION Highly active bisphosphonates are commonly used for the treatment of bone metabolic disorders and they are generally well tolerated. Zoledronic acid may represent a promising alternative to surgical intervention in MS, although its use in rare form of bone fibrous dysplasias is still controversial.
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Affiliation(s)
- Fabio Vescini
- Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia of Udine, 33100 Udine, Italy
| | - Alberto Falchetti
- Villalba Clinic, Villa Maria Group, 40120 Bologna, Italy.,EndOsmet, Villa Donatello Private Hospital, 50100 Florence, Italy
| | - Veronica Tonelli
- Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia of Udine, 33100 Udine, Italy
| | - Maria Carpentieri
- Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia of Udine, 33100 Udine, Italy
| | - Claudia Cipri
- Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia of Udine, 33100 Udine, Italy
| | - Roberta Cosso
- EndOsmet, Villa Donatello Private Hospital, 50100 Florence, Italy
| | - Elda Kara
- Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia of Udine, 33100 Udine, Italy
| | - Vincenzo Triggiani
- Interdisciplinary Department of Medicine-Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases, University of Bari "Aldo Moro", School of Medicine, 70100 Bari, Italy
| | - Franco Grimaldi
- Endocrinology and Metabolism Unit, University-Hospital S. Maria della Misericordia of Udine, 33100 Udine, Italy
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de Azambuja Carvalho PH, Torriani MA, Post LK, Chagas OL. Surgical Treatment of Fibroosseous Lesion in Young Patient with Reduced Mouth Opening. Craniomaxillofac Trauma Reconstr 2018; 11:314-319. [PMID: 30574276 PMCID: PMC6224290 DOI: 10.1055/s-0037-1608697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 07/27/2017] [Indexed: 10/18/2022] Open
Abstract
Fibrous dysplasia is a benign fibroosseous disorder that can affect the maxillary bones, causing aesthetic deformity and functional impairment. This article reports the case of a 13-year-old male patient at the time of diagnosis. The patient showed increased facial volume with relevant asymmetry, having reported the onset of the condition 12 months before. Upon examination, the patient presented an 8-mm mouth opening and an acute inflammatory process associated with tooth 37 pericoronal hood. Upon imaging exam, exuberant bone growth in the left mandibular ramus area of ground glass aspect was observed. After incisional biopsy, fibrous dysplasia was diagnosed and sequentially treated with osteoplasty and coronoid process removal. The patient evolved to a 43-mm mouth opening and favorable aesthetics without recurrence in a 3-year follow-up period. In this case, coronoidectomy and bone plasty proved to be effective, returning aesthetics and function. The patient is supposed to be followed up in the long term.
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Affiliation(s)
- Pedro Henrique de Azambuja Carvalho
- Department of Diagnosis and Oral and Maxillofacial Surgery, Faculdade de Odontologia Campus de Araraquara, Universidade Estadual Paulista Julio de Mesquita Filho, Araraquara, Brazil
| | - Marcos Antonio Torriani
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Letícia Kirst Post
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil
| | - Otacílio Luiz Chagas
- Department of Oral and Maxillofacial Surgery and Maxillofacial Prosthodontics, Faculty of Dentistry, Federal University of Pelotas, Pelotas, Brazil
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30
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Pereira TDSF, Gomes CC, Brennan PA, Fonseca FP, Gomez RS. Fibrous dysplasia of the jaws: Integrating molecular pathogenesis with clinical, radiological, and histopathological features. J Oral Pathol Med 2018; 48:3-9. [PMID: 30376190 DOI: 10.1111/jop.12797] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Fibrous dysplasia is a non-neoplastic developmental process that affects the craniofacial bones, characterized by painless enlargement as a result of bone substitution by abnormal fibrous tissue. Postzygotic somatic activating mutations in the GNAS1 gene cause fibrous dysplasia and have been extensively investigated, as well as being helpful in the differential diagnosis of the disease. Fibrous dysplasia may involve one (monostotic) or multiple bones (polyostotic), sporadically or in association with McCune-Albright syndrome, Jeffe-Lichenstein syndrome, or Mazabreud syndrome. This review summarizes the current knowledge on fibrous dysplasia, emphasizing the value of integrating the understanding of its molecular pathogenesis with the clinical, radiological, and histopathological features. In addition, we address important aspects related to the differential diagnosis and patient management.
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Affiliation(s)
- Thaís Dos Santos Fontes Pereira
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Cavalieri Gomes
- Department of Pathology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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31
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Martini M, Klausing A, Heim N, Fischer HP, Sommer A, Reich RH. Fibrous dysplasia imitating malignancy. J Craniomaxillofac Surg 2018; 46:1313-1319. [PMID: 29859820 DOI: 10.1016/j.jcms.2018.05.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 04/06/2018] [Accepted: 05/07/2018] [Indexed: 11/19/2022] Open
Abstract
Fibrous dysplasia is a benign bone disease, presenting as monostotic or polyostotic lesions, or as part of a syndrome (McCune-Albright/Mazabraud). Its clinical course shows a variegated picture and the progression of its growth is unpredictable. In the workup of 39 fibrous dysplasia cases in the cranio-facial area, four cases presented fast growth tendencies, of which two patients with McCune-Albright syndrome showed malignant-like rapid growth. This local aggressive form is extremely rare, and the concept of this issue has not been clearly defined. With regard to the speed of growth a volumetric-time analysis in one of our cases demonstrated a 74 days tumor doubling rate with an exponential growth curve. According to the literature the aggressive form presented extra-cranially mainly at an adult age, whereas its appearance in our cranio-facial patient collective was much younger. Distinguishing nonmalignant and malignant aggressive forms is difficult and highly inconsistent in the literature. We therefore implemented a quantitative growth measure analysis to define aggressive forms based on progression and speed of growth and impartial of type of FD, localization or functional incapacity. Due to our study findings and literature review we state a prevalence of an aggressive form might be possibly about 5 %.
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Affiliation(s)
- Markus Martini
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany.
| | - Anne Klausing
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Nils Heim
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Hans-Peter Fischer
- Department of Pathology, (Head: Prof. Dr. G. Kristiansen), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Alexandra Sommer
- Department of Radiology, (Head: Prof. Dr. H. H. Schild), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
| | - Rudolf Hermann Reich
- Department of Maxillofacial and Plastic Surgery, (Head: Prof. Dr. Dr. R. H. Reich), University of Bonn, Sigmund-Freud-Str. 25, 53127, Bonn, Germany
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32
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Innamorati G, Wilkie TM, Kantheti HS, Valenti MT, Dalle Carbonare L, Giacomello L, Parenti M, Melisi D, Bassi C. The curious case of Gαs gain-of-function in neoplasia. BMC Cancer 2018; 18:293. [PMID: 29544460 PMCID: PMC5856294 DOI: 10.1186/s12885-018-4133-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 02/15/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Mutations activating the α subunit of heterotrimeric Gs protein are associated with a number of highly specific pathological molecular phenotypes. One of the best characterized is the McCune Albright syndrome. The disease presents with an increased incidence of neoplasias in specific tissues. MAIN BODY A similar repertoire of neoplasms can develop whether mutations occur spontaneously in somatic tissues during fetal development or after birth. Glands are the most "permissive" tissues, recently found to include the entire gastrointestinal tract. High frequency of activating Gαs mutations is associated with precise diagnoses (e.g., IPMN, Pyloric gland adenoma, pituitary toxic adenoma). Typically, most neoplastic lesions, from thyroid to pancreas, remain well differentiated but may be a precursor to aggressive cancer. CONCLUSIONS Here we propose the possibility that gain-of-function mutations of Gαs interfere with signals in the microenvironment of permissive tissues and lead to a transversal neoplastic phenotype.
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Affiliation(s)
- Giulio Innamorati
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Thomas M. Wilkie
- Pharmacology Department, UT Southwestern Medical Center, Dallas, TX USA
| | | | - Maria Teresa Valenti
- Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Luca Dalle Carbonare
- Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Luca Giacomello
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
| | - Marco Parenti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Davide Melisi
- Laboratory of Oncology and Molecular Therapy, Department of Medicine, University of Verona, Verona, Italy
| | - Claudio Bassi
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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33
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Sugiura Y, Kanda H, Motoi N, Nomura K, Inamura K, Okada E, Matsumoto H, Shimoji T, Matsumoto S, Nakayama J, Takazawa Y, Ishikawa Y, Machinami R. Osteosarcoma arising in fibrous dysplasia, confirmed by mutational analysis of GNAS gene. Pathol Res Pract 2018; 214:318-324. [DOI: 10.1016/j.prp.2017.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 10/07/2017] [Indexed: 11/27/2022]
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34
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Majoor BC, Boyce AM, Bovée JV, Smit VT, Collins MT, Cleton-Jansen AM, Dekkers OM, Hamdy NA, Dijkstra PS, Appelman-Dijkstra NM. Increased Risk of Breast Cancer at a Young Age in Women with Fibrous Dysplasia. J Bone Miner Res 2018; 33:84-90. [PMID: 28856726 DOI: 10.1002/jbmr.3286] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 08/19/2017] [Accepted: 08/28/2017] [Indexed: 01/12/2023]
Abstract
Fibrous dysplasia (FD) is a rare bone disorder caused by mutations of the GNAS gene, which are also identified in malignancies. We explored the potential relationship between breast cancer and fibrous dysplasia in two fibrous dysplasia cohorts from the Netherlands and the United States. Data on fibrous dysplasia and breast cancer diagnosis were retrieved from hospital records of 134 (Netherlands) and 121 (US) female patients. Results were validated with breast cancer data of 645 female fibrous dysplasia patients from the Dutch Pathology Registry (PALGA). Standardized morbidity ratios for breast cancer were estimated with data from Dutch and US general population registries. GNAS mutation was analyzed in 9 available breast cancer specimens. A combined total of 15 patients (6 polyostotic, 9 McCune-Albright Syndrome) had breast cancer (87% thoracic localizations). In the Netherlands, a breast cancer incidence rate of 7.5% at median age of 46 years was validated in PALGA (6.5% at age 51 years). Breast cancer risk was 3.4-fold increased (95% confidence interval [CI] 1.6-5.9) compared with the Dutch general population; OR 13.2-fold (95% CI 6.2-22.8) in thoracic disease. In the US cohort, breast cancer incidence rate was 4.5% at a median age of 36 years. Breast cancer risk was 3.9-fold increased (95% CI 1.2-8.2) compared with the general population; 5.7-fold (95% CI 1.4-13.0) in thoracic disease. GNAS mutation was positive in 4 breast cancer specimens (44%). Risk of breast cancer is increased at a younger age, particularly in polyostotic FD, suggesting that screening for breast cancer should be considered in this particular group at a younger age than currently advocated by national guidelines. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Bas Cj Majoor
- Department of Orthopedic Surgery, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
| | - Alison M Boyce
- Section on Skeletal Disorders and Mineral Homeostasis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, USA
| | - Judith Vmg Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vincent Thbm Smit
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael T Collins
- Section on Skeletal Disorders and Mineral Homeostasis, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, USA
| | | | - Olaf M Dekkers
- Department of Medicine, Division of Endocrinology, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology and Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Neveen At Hamdy
- Department of Medicine, Division of Endocrinology, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
| | - Pd Sander Dijkstra
- Department of Orthopedic Surgery, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
| | - Natasha M Appelman-Dijkstra
- Department of Medicine, Division of Endocrinology, Center for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands
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35
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GNAS Mutations in Fibrous Dysplasia: A Comparative Study of Standard Sequencing and Locked Nucleic Acid PCR Sequencing on Decalcified and Nondecalcified Formalin-fixed Paraffin-embedded Tissues. Appl Immunohistochem Mol Morphol 2017; 24:660-667. [PMID: 26574629 DOI: 10.1097/pai.0000000000000242] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
It is well known that fibrous dysplasia (FD) is characterized by the presence of activating mutations involving G-nucleotide binding protein-α subunit (GNAS) involving codon R201 and rarely codon 227 with a mutation frequency between 45% and 93%. Herein, we investigate the sensitivity of detection of GNAS mutations in exons 8 and 9 using a standard and a highly sensitive locked nucleic acid polymerase chain reaction (LNA-PCR) sequencing in 52 cases of FD. In view of the recent report of GNAS mutations in a small number of low-grade osteosarcomas, we also tested in addition 12 cases of low-grade osteosarcomas. GNAS exon 8 mutations p.R201H (31%), p.R201C (15%), and p.R201S (2%) were identified in 50% of FD cases. LNA-PCR sequencing identified only 1 positive case within the mutation negative cases tested by standard PCR and Sanger sequencing. No mutations were identified in any of the low-grade osteosarcomas by standard and LNA-PCR sequencing. There was no association between age, site, size, specimen type, and mutational status. No exon 9 or codon 227 mutations were identified in any of tested cases. There was a significant difference in the sensitivity of the assay between decalcified and nondecalcified FDs (31% vs. 70%, P=0.002). LNA-PCR has no added value in enhancing detection sensitivity for GNAS mutations in FD. In addition to decalcification, innate somatic mosaicism contributes to the decreased sensitivity in mutation detection.
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36
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Shin SJ, Lee SJ, Kim SK. Frequency of GNAS R201H substitution mutation in polyostotic fibrous dysplasia: Pyrosequencing analysis in tissue samples with or without decalcification. Sci Rep 2017; 7:2836. [PMID: 28588314 PMCID: PMC5460223 DOI: 10.1038/s41598-017-03093-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/21/2017] [Indexed: 11/09/2022] Open
Abstract
Guanine nucleotide-binding protein/α-subunit (GNAS) mutations are involved in fibrous dysplasia (FD) pathogenesis. Here, we analyzed GNAS mutations in FD which were performed by pyrosequencing DNA isolated from formalin-fixed paraffin-embedded (FFPE) tissue. The mutation detection rate was determined in FD specimens with and without decalcification. GNAS mutation was identified in 28 cases out of 87 FDs (32.18%) [p.R201C (N = 14) and p.R201H (N = 14)]. GNAS mutation was more likely to occur in polyostotic FD (7/28, 25.0%); FD without GNAS mutation was mostly monostotic form (56/59, 94.9%, P = 0.011). The G > A (R201H) mutation was more frequent in polyostotic FD (6/14 patients, 42.9%) than the C > T (R201C) mutation (1/14, 7.1%) (P = 0.077). We divided the FD cases into two subgroups: tissue specimens that were not decalcified (N = 35, 40.2%), and tissue specimens that were decalcified (N = 52, 59.8%). GNAS mutation was more frequently identified in FD specimens that were not subjected to decalcification (23/35, 65.7%) than in FD specimens that were decalcified (5/52, 9.6%) (P = 0.001). In conclusion, mutation analysis of GNAS by pyrosequencing has diagnostic value in FFPE tissue of patients with FD, especially in specimens that were not decalcified. The R201H substitution mutation of GNAS may be involved in the pathogenesis of polyostotic FD.
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Affiliation(s)
- Su-Jin Shin
- Department of Pathology, Hanyang University College of Medicine, Seoul, Korea
| | - Seok Joo Lee
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Kyum Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.
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37
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La dysplasie fibreuse osseuse cranio-faciale. Rev Med Interne 2016; 37:834-839. [DOI: 10.1016/j.revmed.2016.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/04/2015] [Accepted: 02/23/2016] [Indexed: 11/22/2022]
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Abstract
The posterior skull base can be involved by a variety of pathologic processes. They can be broadly classified as: traumatic, neoplastic, vascular, and inflammatory. Pathology in the posterior skull base usually involves the lower cranial nerves, either as a source of pathology or a secondary source of symptoms. This review will categorize pathology arising in the posterior skull base and describe how it affects the skull base itself and surrounding structures.
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Affiliation(s)
- Joici Job
- Department of Radiology, University of Pittsburgh Medical Center, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA
| | - Barton F Branstetter
- Department of Radiology, University of Pittsburgh Medical Center, University of Pittsburgh, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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39
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Oostenbroek-Bisschop JSLI, Verweij JP, van Merkesteyn JPR. Custom Made Replacement of the Mandibular Condyle in a Case of Fibrous Dysplasia with Cystic Degeneration; A Case Report. Dent J (Basel) 2016; 4:dj4040042. [PMID: 29563484 PMCID: PMC5806957 DOI: 10.3390/dj4040042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 11/07/2016] [Accepted: 11/09/2016] [Indexed: 11/16/2022] Open
Abstract
This paper describes a rare case of fibrous dysplasia with cystic degeneration in the mandibular condyle. Diagnostic and therapeutic considerations are discussed. A 40-year old woman presented with pain near the region of her right ear. Physical and radiographic examination showed no abnormalities besides the presence of a mixed radiopaque/radiolucent expansive lesion of the right condyle. Pathologic examination showed high bone-turnover with bone formation. Bone scintigraphy showed a monostotic active fibrous lesion in the right part of the mandible. Bisphosphonate treatment did not sufficiently treat the patient's symptoms and physiotherapy to treat craniomandibular dysfunction as a factor in the pain was also unsuccessful. The patient later developed an acute external otitis due to a narrowed outer ear canal and had to be admitted to the hospital for treatment with intravenous antibiotics. Approximately two years after first presentation, resection of the affected bone (condylectomy) and reconstruction with a custom total joint prosthesis was indicated due to repeated functional deficits with considerable morbidity. Pathologic examination of the resected mandibular condyle showed increased bone formation including formation of neocortex and some cystic formation. This was diagnosed as fibrous dysplasia with cystic degeneration. Approximately two years after surgery, the patient functioned well.
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Affiliation(s)
| | - Jop P Verweij
- Department of Oral and Maxillofacial Surgery & Special Dental Care, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands.
| | - J P Richard van Merkesteyn
- Department of Oral and Maxillofacial Surgery & Special Dental Care, Leiden University Medical Centre, 2333 ZA Leiden, The Netherlands.
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40
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Fibrous dysplasia. Clinical review and therapeutic management. Med Clin (Barc) 2016; 147:547-553. [PMID: 27765282 DOI: 10.1016/j.medcli.2016.07.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 07/28/2016] [Accepted: 07/31/2016] [Indexed: 12/19/2022]
Abstract
Fibrous dysplasia is a skeletal disorder that is associated with a wide spectrum of clinical manifestations, including localized asymptomatic forms and extensive severe forms with severe bone deformities and endocrinological alterations, depending on age, location, extent and associated processes. Although the treatment of choice is based on bisphosphonates, the therapeutic efficacy of these agents in the control of disease activity remains uncertain. This article reviews the current data available on the treatment of this disease as well as the preliminary data on new therapeutic approaches.
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41
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Noh BJ, Sung JY, Kim YW, Araujo ES, Kalil RK, Jung WW, Kim HS, Park YK. Clinicopathological implications of GNAS in Ewing sarcoma. Oncol Lett 2016; 11:4077-4082. [PMID: 27313744 DOI: 10.3892/ol.2016.4521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 01/19/2016] [Indexed: 01/08/2023] Open
Abstract
The objective of the present study was to determine whether guanine nucleotide-binding protein α stimulating (GNAS) gene expression correlates with pathognomonic signs by analyzing the mutations, methylation status and G-protein α subunit (Gsα) expression of GNAS in Ewing sarcoma (ES). Formalin-fixed paraffin-embedded tissue samples from 77 patients with primary ES were obtained in South Korea, Argentina and Brazil, and were studied via methylation chip assay and direct sequencing of the GNAS gene and immunohistochemical analysis of Gsα. The mutation and methylation statuses of the GNAS gene were examined. Immunohistochemical results were measured with respect to proportion and staining intensity. The results revealed that GNAS genes in ES tumor samples were less methylated compared with normal controls. No mutations were detected at exons 8 or 9 of the GNAS locus complex on chromosome 20q13.3, indicating that the pathogenesis of ES was not associated with GNAS mutation. Gsα expression correlated well with the methylation status of the GNAS gene. Notably, high Gsα expression was detected more frequently in samples from living patients than from decedents, although this was not statistically significant (P=0.055). In conclusion, GNAS mutation is not associated with the pathogenesis of ES tumors. This finding may be used to differentiate ES tumors from metastatic bone lesions with morphological similarity to ES tumors. Analysis of the methylation status of the GNAS gene and immunohistochemical Gsα expression suggests that hypermethylated GNAS (low Gsα expression) in ES may be associated with unfavorable progression with a non-significant trend.
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Affiliation(s)
- Byeong-Joo Noh
- Department of Pathology, School of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Ji-Youn Sung
- Department of Pathology, School of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Youn Wha Kim
- Department of Pathology, School of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
| | - Eduardo Santini Araujo
- Laboratory of Orthopedic Pathology, Central Army Hospital, Buenos Aires C1426BOR, Argentina
| | - Ricardo Karam Kalil
- Molecular Pathology Division, SARAH Network of Rehabilitation Hospitals, Brasilia 70335-901, Brazil
| | - Woon-Won Jung
- Department of Biomedical Laboratory Science, College of Health Science, Korea University, Seoul 02708, Republic of Korea
| | - Hyun-Sook Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Cheongju University, Chungcheongbuk 28503 Republic of Korea
| | - Yong-Koo Park
- Department of Pathology, School of Medicine, Kyung Hee University Hospital, Seoul 02447, Republic of Korea
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42
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Morioka H, Kamata Y, Nishimoto K, Susa M, Kikuta K, Horiuchi K, Sasaki A, Kameyama K, Nakamura M, Matsumoto M. Fibrous Dysplasia with Massive Cartilaginous Differentiation (Fibrocartilaginous Dysplasia) in the Proximal Femur: A Case Report and Review of the Literature. Case Rep Oncol 2016; 9:126-33. [PMID: 27293399 PMCID: PMC4899633 DOI: 10.1159/000443476] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Fibrous dysplasia (FD) is a monostotic or polyostotic benign bone lesion with spindle-cell proliferation in woven bone and stroma. Rarely, cartilaginous differentiation can be seen in the lesions of FD. FD with massive cartilaginous differentiation is called fibrocartilaginous dysplasia (FCD) and is considered a rare variant of FD. Although pathological findings of FD show irregular immature bone formation without osteoblastic rimming in fibrous tissue, and rarely show very small amounts of cartilage, histological images of FCD are said to show that cartilage with a relatively high cell density is present in the majority and that FD-like findings are seen in parts of it. The most characteristic feature of FCD on images is calcification in the lesions reflecting cartilaginous tissue. On the other hand, typical radiographic findings of FD include shadows with a ground-glass appearance and thinning and bulging of the cortical bone, the observation if calcification is not usual. Therefore, in the diagnosis of FCD, differentiation from multiple enchondromatosis, Ollier disease, chondrosarcoma, and chondrosarcoma secondary to FD is necessary, and it seems important to make a careful diagnosis based not only on the pathological findings but also on imaging and clinical findings. Herein, we report on a case of FD of the proximal femur associated with intralesional extensive carti laginous differentiation in which a pathological fracture occurred during follow-up, with a review of the literature.
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Affiliation(s)
- Hideo Morioka
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Yasuhiro Kamata
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Kazumasa Nishimoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Michiro Susa
- Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Kazutaka Kikuta
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Keisuke Horiuchi
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Aya Sasaki
- Division of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan
| | - Kaori Kameyama
- Division of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan
| | - Masaya Nakamura
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Morio Matsumoto
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
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43
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Abstract
Diversity is the basis of fitness selection. Although the genome of an individual is considered to be largely stable, there is theoretical and experimental evidence--both in model organisms and in humans--that genetic mosaicism is the rule rather than the exception. The continuous generation of cell variants, their interactions and selective pressures lead to life-long tissue dynamics. Individuals may thus enjoy 'clonal health', defined as a clonal composition that supports healthy morphology and physiology, or suffer from clonal configurations that promote disease, such as cancer. The contribution of mosaicism to these processes starts during embryonic development. In this Opinion article, we argue that the road to cancer might begin during these early stages.
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Affiliation(s)
- Luis C Fernández
- Epithelial Carcinogenesis Group, Cancer Cell Biology Programme, Spanish National Cancer Research Centre-CNIO, Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Miguel Torres
- Centro Nacional de Investigaciones Cardiovasculares-CNIC, Melchor Fernández Almagro 3, 28029 Madrid, Spain
| | - Francisco X Real
- Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, Barcelona, and at the Epithelial Carcinogenesis Group, Cancer Cell Biology Programme, Spanish National Cancer Research Centre-CNIO, 28029 Madrid, Spain
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44
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A new subtype of high-grade mandibular osteosarcoma with RASAL1/MDM2 amplification. Hum Pathol 2015; 50:70-8. [PMID: 26997440 DOI: 10.1016/j.humpath.2015.11.012] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2015] [Revised: 11/16/2015] [Accepted: 11/22/2015] [Indexed: 12/18/2022]
Abstract
In contrast to long bone osteosarcoma, mandibular osteosarcoma is highly heterogeneous and morphologically overlaps with benign tumors, obscuring diagnosis and treatment selection. Molecular characterization is difficult due to the paucity of available specimens of this rare disease. We aimed to characterize the spectrum of mandibular osteosarcoma using immunohistochemistry and molecular techniques (quantitative polymerase chain reaction and sequencing) and compare them with benign fibro-osseous lesions. Forty-nine paraffin-embedded mandible osteosarcoma tissue samples were collected retrospectively and compared with 10 fibrous dysplasia and 15 ossifying fibroma cases. These were analyzed for molecular markers thought to differ between the different diseases and subtypes: MDM2 (murine double-minute type 2) overexpression, GNAS (guanine nucleotide-binding protein/α subunit) mutations, and amplification of MDM2 and/or RASAL1 (RAS protein activator like 1). Five fibroblastic high-grade osteosarcoma subtypes showed MDM2 amplification, including 2 with a microscopic appearance of high-grade osteosarcoma with part low-grade osteosarcoma (differentiated/dedifferentiated osteosarcoma) and MDM2 overexpression. The other 3 contained a coamplification of MDM2 and RASAL1, a signature also described for juvenile ossifying fibroma, with no overexpression of MDM2. These were of the giant cell-rich high-grade osteosarcoma, with areas mimicking juvenile ossifying fibroma (ossifying fibroma-like osteosarcoma). Our results show that some diagnosed high-grade osteosarcomas are differentiated/dedifferentiated osteosarcomas and harbor an overexpression and amplification of MDM2. In addition, juvenile ossifying fibromas can potentially evolve into giant cell-rich high-grade osteosarcomas and are characterized by a RASAL1 amplification (osteosarcoma with juvenile ossifying fibroma-like genotype). Thus, the presence of a RASAL1 amplification in ossifying fibroma may indicate a requirement for closer follow-up and more aggressive management.
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45
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Abstract
Pathologic diagnosis of primary bone neoplasms can be challenging primarily due to rarity of the disease entities, overlapping imaging and histologic findings, and lack of tumor-specific immunohistochemical stains. Although slow to evolve, in recent years there has been a rapid advance in the discovery of new and novel molecular markers in primary bone neoplasms, which has enhanced diagnostic accuracy and has shed light into their pathogenesis. Modern technological approaches such as next-generation sequencing including RNA sequencing are serving as "rapid discovery platforms" for new and novel mutations and translocations with diagnostic, prognostic, and possible therapeutic applicability. As next-generation sequencing technologies are finding their place in clinical laboratories, one could envision routine testing for mutations spanning across a gene or translocations with multiple breakpoints and partner genes. This review will focus on the clinical relevance and applicability of molecular markers in primary bone neoplasms with examples.
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46
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Salinas-Souza C, De Andrea C, Bihl M, Kovac M, Pillay N, Forshew T, Gutteridge A, Ye H, Amary MF, Tirabosco R, Toledo SRC, Baumhoer D, Flanagan AM. GNAS mutations are not detected in parosteal and low-grade central osteosarcomas. Mod Pathol 2015; 28:1336-42. [PMID: 26248895 DOI: 10.1038/modpathol.2015.91] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2015] [Revised: 06/09/2015] [Accepted: 06/15/2015] [Indexed: 11/08/2022]
Abstract
Parosteal osteosarcoma, low-grade central osteosarcoma, and fibrous dysplasia share similar histological features that may pose a diagnostic challenge. The detection of GNAS mutations in primary bone tumors has been useful in clinical practice for diagnosing fibrous dysplasia. However, the recent report of GNAS mutations being detected in a significant proportion of parosteal osteosarcoma challenges the specificity of this mutation. As the number of cases reported in this study was small we set out to determine if these results could be reproduced. We studied 97 formalin-fixed paraffin-embedded low-grade osteosarcomas from 90 patients including 62 parosteal osteosarcomas, of which MDM2 amplification was detected in 79%, 11 periosteal osteosarcomas and 24 low-grade central osteosarcoma samples. The mutational status of GNAS was analyzed in codons p.R201, p.Q227, and other less common GNAS alterations by bidirectional Sanger sequencing and/or next generation sequencing using the Life Technologies Ion Torrent platform. GNAS mutations were not detected in any of the low-grade osteosarcomas from which informative DNA was extracted. Our findings therefore support prior observations that GNAS mutations are highly specific for fibrous dysplasia and occur rarely, if ever, in parosteal and other low-grade osteosarcomas.
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Affiliation(s)
- Carolina Salinas-Souza
- UCL Advanced Diagnostics Molecular Profiling Laboratory, Sarah Cannon-UCL Laboratories, UCL Cancer Institute, London, UK
- Pediatric Oncology Institute/Federal University of São Paulo, São Paulo, Brazil
| | - Carlos De Andrea
- UCL Advanced Diagnostics Molecular Profiling Laboratory, Sarah Cannon-UCL Laboratories, UCL Cancer Institute, London, UK
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, UK
| | - Michel Bihl
- Institute of Pathology, University Hospital Basel, Basel, Switzerland
| | - Michal Kovac
- Bone Tumour Reference Centre, University Hospital Basel, Basel, Switzerland
| | - Nischalan Pillay
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, UK
- UCL Cancer Institute, London, UK
| | | | | | - Hongtao Ye
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, UK
| | - M Fernanda Amary
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, UK
- UCL Cancer Institute, London, UK
| | - Roberto Tirabosco
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, UK
| | | | - Daniel Baumhoer
- Bone Tumour Reference Centre, University Hospital Basel, Basel, Switzerland
| | - Adrienne M Flanagan
- Royal National Orthopaedic Hospital NHS Trust, Stanmore, Middlesex, UK
- UCL Cancer Institute, London, UK
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48
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Nishida Y, Tsukushi S, Hosono K, Nakashima H, Yamada Y, Urakawa H, Ishiguro N. Surgical treatment for fibrous dysplasia of femoral neck with mild but prolonged symptoms: a case series. J Orthop Surg Res 2015; 10:63. [PMID: 25958111 PMCID: PMC4429415 DOI: 10.1186/s13018-015-0208-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Accepted: 03/14/2015] [Indexed: 11/11/2022] Open
Abstract
Background The proximal femur is one of the most common sites involved by fibrous dysplasia. In cases with mild deformity that does not require corrective surgery, occasional patients suffer sustained pain because of repeated microfractures. This study aimed to clarify the outcomes of surgery with autogenous fibular cortical strut grafting and compression hip screw fixation. Methods Since 2002, eight consecutive patients (nine hips) with femoral neck fibrous dysplasia without severe deformity were prospectively treated with autogenous fibular strut grafting and compression hip screw fixation. Results Mean age of patients was 35 years. Mean follow-up of patients after surgery was 75 months. Most of the patients could walk with full weight-bearing 2 weeks after surgery. Functional score of lower extremity was significantly improved from 65 % to 95 % (P = 0.001). Femoral neck angle was increased from 127 to 130. Donor site of strut cortical fibula showed good regeneration with β-tricalcium phosphate. Conclusions Autogenous fibular cortical strut grafting and compression hip screw fixation achieved good post-operative function and provided an early return to work for adult patients with fibrous dysplasia of the femoral neck with mild but prolonged symptoms. Morbidity in the donor site of fibula strut is minimal with the use of β-tricalcium phosphate.
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Affiliation(s)
- Yoshihiro Nishida
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
| | - Satoshi Tsukushi
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
| | - Kozo Hosono
- Orthopaedic Surgery, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kake-machi, Okazaki City, Aichi, Japan.
| | - Hiroatsu Nakashima
- Orthopaedic Surgery, Aichi Cancer Center Aichi Hospital, 18 Kuriyado, Kake-machi, Okazaki City, Aichi, Japan. .,Present address: Orthopaedic Surgery, Gifu Prefectural Tajimi Hospital, 5-161, Maehata, Tajimi, Gifu, Japan.
| | - Yoshihisa Yamada
- Orthopaedic Surgery, Nagoya Memorial Hospital, 4-305 Hirabari, Tenpaku-ku, Nagoya, Japan.
| | - Hiroshi Urakawa
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
| | - Naoki Ishiguro
- Department of Orthopaedic Surgery, Nagoya University Graduate School and School of Medicine, 65 Tsurumai, Showa, Nagoya, Aichi, 466-8550, Japan.
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49
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Soltero-Rivera M, Engiles JB, Reiter AM, Reetz J, Lewis JR, Sánchez MD. Benign and Malignant Proliferative Fibro-osseous and Osseous Lesions of the Oral Cavity of Dogs. Vet Pathol 2015; 52:894-902. [DOI: 10.1177/0300985815583096] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Ossifying fibroma (OF) and fibrous dysplasia (FD) are benign, intraosseous, proliferative fibro-osseous lesions (PFOLs) characterized by replacement of normal bone by a fibrous matrix with various degrees of mineralization and ossification. Osteomas are benign tumors composed of mature, well-differentiated bone. Clinical, imaging, and histologic features of 15 initially diagnosed benign PFOLs and osteomas of the canine oral cavity were evaluated. Final diagnoses after reevaluation were as follows: OF (3 cases), FD (4 cases), low-grade osteosarcoma (LG-OSA) (3 cases), and osteoma (5 cases). Histology alone often did not result in a definitive diagnosis for PFOL. OF appeared as a well-circumscribed, radiopaque mass with some degree of bone lysis on imaging. Most lesions of FD showed soft tissue opacity with bone lysis and ill-defined margins. Low-grade OSA appeared as a lytic lesion with a mixed opacity and ill-defined margins. Osteomas were characterized by a mineralized, expansile, well-circumscribed lesion. Although histologic features of PFOLs were typically bland, the lesions diagnosed as LG-OSA had some features of malignancy (eg, bone invasion or a higher mitotic index). Treatment varied widely. Of the 10 dogs with benign PFOL or osteoma with known outcome (10/12), 9 showed either complete response (6/10) or stable disease (3/10) after treatment. Of the 2 dogs with LG-OSA with known outcome, 1 showed complete response after curative intent surgery, but 1 patient had recurrence after partial maxillectomy. Definitive diagnosis of mandibular/maxillary PFOL is challenging via histopathologic examination alone, and accurate diagnosis is best achieved through assimilation of clinical, imaging, and histopathologic features.
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Affiliation(s)
- M. Soltero-Rivera
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J. B. Engiles
- Department of Pathology and Toxicology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A. M. Reiter
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J. Reetz
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - J. R. Lewis
- Department of Clinical Studies, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M. D. Sánchez
- Department of Pathology and Toxicology, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA, USA
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50
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Chromosome 12 long arm rearrangement covering MDM2 and RASAL1 is associated with aggressive craniofacial juvenile ossifying fibroma and extracranial psammomatoid fibro-osseous lesions. Mod Pathol 2015; 28:48-56. [PMID: 24925056 DOI: 10.1038/modpathol.2014.80] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 01/31/2014] [Accepted: 04/04/2014] [Indexed: 12/19/2022]
Abstract
To evaluate the diagnostic value of MDM2 status in craniofacial fibro-osseous lesions, we investigated MDM2 expression by immunohistochemistry and analyzed MDM2 amplification by qPCR in 30 cases of ossifying fibroma (including 13 cases of the juvenile variant) and 17 cases of fibrous dysplasia. Two cases of uncommon extragnathic psammomatoid fibrous dysplasia and a mixed control group of 15 cases of low-grade osteosarcoma and 15 cases of well-differentiated/dedifferentiated liposarcoma were included. MDM2 amplification was found in 33% of ossifying fibromas (peak of 69% for the juvenile variant) and in 12% of fibrous dysplasia, in none of which was MDM2 overexpressed. All control cases exhibited MDM2 amplification and overexpression. To investigate possible polysomy of chromosome 12, we studied RASAL1 amplification, a gene telomeric to MDM2 on the long arm of chromosome 12. RASAL1 amplification was reported in all benign fibro-osseous lesions exhibiting MDM2 amplification but not in controls. Simultaneous amplification of these two genes was significantly higher in juvenile ossifying fibromas compared with fibrous dysplasia (P=0.004), non-juvenile ossifying fibromas (P=0.001), and all other benign craniofacial fibro-osseous lesions combined (P=0.0001). Of the nine cases of juvenile ossifying fibroma exhibiting amplification, three were locally invasive and four were recurrent, suggesting aggressive disease. The two cases of extragnathic psammomatoid fibrous dysplasia also showed MDM2 and RASAL1 amplification with no MDM2 overexpression. This large chromosome 12 rearrangement, spanning MDM2 and RASAL1, is the first recurrent molecular abnormality to be reported in juvenile ossifying fibroma. It may represent both a molecular diagnostic marker and a characteristic of more aggressive forms with a higher risk of recurrence. Finally, the presence of this rearrangement in extragnathic psammomatoid fibro-osseous lesions mimicking ossifying fibromas might reflect a common molecular pathway in their pathogenesis and calls into question the classification of such lesions within fibrous dysplasia.
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