1
|
Holst S, Weber AK, Meier F, Otte J, Petzsch P, Reifenberger J, Wachtmeister T, Westphal D, Ziemer M, Wruck W, Adjaye J, Betz RC, Rütten A, Surowy HM, Redler S. Gene expression profiling in porocarcinoma indicates heterogeneous tumor development and substantiates poromas as precursor lesions. J Dtsch Dermatol Ges 2024. [PMID: 38899945 DOI: 10.1111/ddg.15445] [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: 05/15/2023] [Accepted: 04/02/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Malignant sweat gland tumors are rare, with the most common being eccrine porocarcinoma (EP). Approximately 18% of benign eccrine poroma (EPO) transit to EP. Previous research has provided first insights into the mutational landscape of EP. However, only few studies have performed gene expression analyses. This leaves a gap in the understanding of EP biology and potential drivers of malignant transformation from EPO to EP. METHODS Transcriptome profiling of 23 samples of primary EP and normal skin (NS). Findings from the EP samples were then tested in 17 samples of EPO. RESULTS Transcriptome profiling revealed diversity in gene expression and indicated biologically heterogeneous sub-entities as well as widespread gene downregulation in EP. Downregulated genes included CD74, NDGR1, SRRM2, CDC42, ANXA2, KFL9 and NOP53. Expression levels of CD74, NDGR1, SRRM2, ANXA2, and NOP53 showed a stepwise-reduction in expression from NS via EPO to EP, thus supporting the hypothesis that EPO represents a transitional state in EP development. CONCLUSIONS We demonstrated that EP is molecularly complex and that evolutionary trajectories correspond to tumor initiation and progression. Our results provide further evidence implicating the p53 axis and the EGFR pathway. Larger samples are warranted to confirm our findings.
Collapse
Affiliation(s)
- Svenja Holst
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Anna K Weber
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Friedegund Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Germany
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany
| | - Jörg Otte
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Childhood Cancer Research Unit, Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Patrick Petzsch
- Biological and Medical Research Centre (BMFZ), Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Julia Reifenberger
- Department of Dermatology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Thorsten Wachtmeister
- Biological and Medical Research Centre (BMFZ), Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dana Westphal
- Department of Dermatology, University Hospital Carl Gustav Carus, TU Dresden, Germany
- Skin Cancer Center at the University Cancer Centre Dresden and National Center for Tumor Diseases, Dresden, Germany
| | - Mirjana Ziemer
- Department of Dermatology, University Medical Center Leipzig, Leipzig, Germany
| | - Wasco Wruck
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - James Adjaye
- Institute for Stem Cell Research and Regenerative Medicine, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Regina C Betz
- Institute of Human Genetics, University of Bonn, Medical Faculty and University Hospital Bonn, Bonn, Germany
| | - Arno Rütten
- Dermatopathology, Bodensee, Siemensstrasse 6/1, 88048, Friedrichshafen, Germany
| | - Harald M Surowy
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Silke Redler
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| |
Collapse
|
2
|
Nguyen AJ, Johnson E, Camilleri M, Wieland C, Lehman JS, Agrawal S, Comfere N, Fadra N, Knudson RA, Greipp P, Halling K, Ray Guo R. Ancillary immunohistochemical and molecular testing in the classification of cutaneous sweat gland/duct neoplasms: A validation study with emphasis on histomorphologic correlation and pathological diagnosis. Hum Pathol 2024; 150:1-8. [PMID: 38876201 DOI: 10.1016/j.humpath.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Revised: 06/09/2024] [Accepted: 06/11/2024] [Indexed: 06/16/2024]
Abstract
Sweat gland neoplasms represent a challenging area of dermatopathology, as they are relatively uncommon and often histopathologically complex. Recent studies have uncovered distinct immunohistochemical and molecular profiles in several sweat gland neoplasms, including digital papillary adenocarcinoma (DPA), papillary eccrine adenoma/tubular apocrine adenoma (PEA/TAA), poroid family tumors (PFT)/porocarcinoma, and clear cell hidradenoma (CCH)/clear cell hidradenocarcinoma (CCHCa). To further evaluate the diagnostic utility of ancillary studies in various sweat gland neoplasms, we performed an independent validation study in a cohort of patients with acral and non-acral tumors (9 DPA, 8 PEA/TAA, 13 PFT, 5 porocarcinoma, 23 CCH, 7 CCHCa, 6 sweat gland carcinoma not otherwise specified). p63 immunohistochemistry (IHC) demonstrated a myoepithelial pattern in 8/8 DPA and 4 of 4 tested PEA/TAA cases, and showed a ductal pattern in all tested PFT/porocarcinoma and CCH/CCHCa cases (42/42). All PEA/TAA (8/8) cases were positive for BRAF V600E IHC. 5 of 12 tested PFT and 5/5 porocarcinoma cases showed either positive staining with NUT IHC or harbored YAP1::NUTM1 fusion gene by RNA sequencing. MAML2 fluorescence in situ hybridization (FISH) was positive in all CCH and CCHCa cases (23/23 and 7/7, respectively). Our results further support the usefulness of appropriate ancillary studies in precise classification of sweat gland tumors, which may be routinely applied in diagnostic pathology practice when morphologic evaluation is in doubt.
Collapse
Affiliation(s)
- Amanda J Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Emma Johnson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Michael Camilleri
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Carilyn Wieland
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Julia S Lehman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Shruti Agrawal
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Nneka Comfere
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, 55905, USA; Department of Dermatology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Numrah Fadra
- Division of Computational Biology, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ryan A Knudson
- Cytogenetics Core Laboratory, Mayo Clinic, Rochester, MN, 55905, USA
| | - Patricia Greipp
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, 55905, USA
| | - Kevin Halling
- Division of Laboratory of Genetics and Genomics, Mayo Clinic, Rochester, MN, 55905, USA
| | - Ruifeng Ray Guo
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL, 32224, USA.
| |
Collapse
|
3
|
Vincenzi M, Mercurio FA, Autiero I, Leone M. Cancer-Related Mutations in the Sam Domains of EphA2 Receptor and Ship2 Lipid Phosphatase: A Computational Study. Molecules 2024; 29:1024. [PMID: 38474536 DOI: 10.3390/molecules29051024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/09/2024] [Accepted: 02/22/2024] [Indexed: 03/14/2024] Open
Abstract
The lipid phosphatase Ship2 interacts with the EphA2 receptor by forming a heterotypic Sam (sterile alpha motif)-Sam complex. Ship2 works as a negative regulator of receptor endocytosis and consequent degradation, and anti-oncogenic effects in cancer cells should be induced by hindering its association with EphA2. Herein, a computational approach is presented to investigate the relationship between Ship2-Sam/EphA2-Sam interaction and cancer onset and further progression. A search was first conducted through the COSMIC (Catalogue of Somatic Mutations in Cancer) database to identify cancer-related missense mutations positioned inside or close to the EphA2-Sam and Ship2-Sam reciprocal binding interfaces. Next, potential differences in the chemical-physical properties of mutant and wild-type Sam domains were evaluated by bioinformatics tools based on analyses of primary sequences. Three-dimensional (3D) structural models of mutated EphA2-Sam and Ship2-Sam domains were built as well and deeply analysed with diverse computational instruments, including molecular dynamics, to classify potentially stabilizing and destabilizing mutations. In the end, the influence of mutations on the EphA2-Sam/Ship2-Sam interaction was studied through docking techniques. This in silico approach contributes to understanding, at the molecular level, the mutation/cancer relationship by predicting if amino acid substitutions could modulate EphA2 receptor endocytosis.
Collapse
Affiliation(s)
- Marian Vincenzi
- Institute of Biostructures and Bioimaging, Via Pietro Castellino 111, 80131 Naples, Italy
| | - Flavia Anna Mercurio
- Institute of Biostructures and Bioimaging, Via Pietro Castellino 111, 80131 Naples, Italy
| | - Ida Autiero
- Institute of Biostructures and Bioimaging, Via Pietro Castellino 111, 80131 Naples, Italy
| | - Marilisa Leone
- Institute of Biostructures and Bioimaging, Via Pietro Castellino 111, 80131 Naples, Italy
| |
Collapse
|
4
|
Kervarrec T, Pissaloux D, Tirode F, de la Fouchardière A, Sohier P, Frouin E, Hamard A, Houben R, Schrama D, Barlier A, Cribier B, Battistella M, Macagno N. Gene fusions in poroma, porocarcinoma and related adnexal skin tumours: An update. Histopathology 2024; 84:266-278. [PMID: 37609771 DOI: 10.1111/his.15023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023]
Abstract
Poroma is a benign sweat gland tumour showing morphological features recapitulating the superficial portion of the eccrine sweat coil. A subset of poromas may transform into porocarcinoma, its malignant counterpart. Poroma and porocarcinoma are characterised by recurrent gene fusions involving YAP1, a transcriptional co-activator, which is controlled by the Hippo signalling pathway. The fusion genes frequently involve MAML2 and NUTM1, which are also rearranged in other cutaneous and extracutaneous neoplasms. We aimed to review the clinical, morphological and molecular features of this category of adnexal neoplasms with a special focus upon emerging differential diagnoses, and discuss how their systematic molecular characterisation may contribute to a standardisation of diagnosis, more accurate classification and, ultimately, refinement of their prognosis and therapeutic modalities.
Collapse
Affiliation(s)
- Thibault Kervarrec
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, University Hospital of Tours, Tours, France
- 'Biologie des infections à polyomavirus' Team, UMR1282 INRAE, University of Tours, Tours, France
| | | | - Franck Tirode
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Arnaud de la Fouchardière
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Biopathology, Center Léon Bérard, Lyon, France
- Centre Léon Bérard, Cancer Research Center of Lyon, Equipe Labellisée, University of Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Lyon, France
| | - Pierre Sohier
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, Hôpital Cochin, AP-HP, AP-HP Centre - Université Paris Cité, Paris, France
- Faculté de Médecine, University Paris Cité, Paris, France
| | - Eric Frouin
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, University Hospital of Poitiers, University of Poitiers, LITEC, Poitiers, France
| | - Aymeric Hamard
- Department of Pathology, University Hospital of Tours, Tours, France
| | - Roland Houben
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - David Schrama
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Anne Barlier
- Aix-Marseille Univ, INSERM, MMG, U1251, Marmara Institute, Marseille, France
- Laboratory of Molecular Biology, La Conception Hospital, Marseille, France
| | - Bernard Cribier
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Clinique Dermatologique, Hôpital Civil, Hôpitaux Universitaires, Université de Strasbourg, Strasbourg, France
| | - Maxime Battistella
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Department of Pathology, Hospital Saint-Louis, AP-HP, Université Paris Cité, INSERM U976, Paris, France
| | - Nicolas Macagno
- CARADERM, French Network of Rare Cutaneous Cancer, Lille, France
- Aix-Marseille Univ, INSERM, MMG, U1251, Marmara Institute, Marseille, France
- Department of Pathology, APHM, Timone University Hospital, Marseille, France
| |
Collapse
|
5
|
Grube VL, Ahmed S, McCoy K, Ashi S, Hafeez F. Whole-Exome Sequencing of a Case of Squamoid Eccrine Ductal Carcinoma Reveal Similarities With Cutaneous Squamous Cell Carcinoma. Am J Dermatopathol 2023; 45:495-498. [PMID: 37249370 DOI: 10.1097/dad.0000000000002456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
ABSTRACT Squamoid eccrine ductal carcinoma (SEDC) is a poorly documented but likely underrecognized sweat gland malignancy with significant risk for local recurrence and potential for metastasis and rare disease-related mortality. Histopathologically, the tumor demonstrates a biphasic differentiation pattern: superficially, the tumor has squamous differentiation [indistinguishable from well-differentiated cutaneous squamous cell carcinoma (cSCC)], while the deeper aspect has a more infiltrative pattern with prominent ductal differentiation. Diagnosis of SEDC relies upon histopathologic examination alone. Its pathogenesis is poorly understood, and its genomic features have yet to be described. In this article, we characterize the genomic features in a case of SEDC through whole-exome sequencing, then compare its features with cSCC and other eccrine ductal carcinomas. Whole-exome sequencing revealed 30 mutations/Mb with 21 pathogenic or likely pathogenic mutations in total, identified across 14 different genes. The genomic abnormalities identified in this case of SEDC overlap considerably with those found in cSCC but not those of other sweat gland malignancies. The clinical and histopathologic features of SEDC previously reported and the genetic features determined from this case suggest that this tumor may arise initially as a well-differentiated cSCC that subsequently undergoes divergent differentiation focally to resemble a sweat gland malignancy. Genetic analyses of additional cases are warranted to clarify this consideration.
Collapse
Affiliation(s)
- Vanden Lamar Grube
- Department of Dermatology, St. Luke's/Temple University Lewis Katz School of Medicine, Bethlehem, PA; and
| | - Sarah Ahmed
- Department of Dermatology, St. Luke's University Health System, St. Luke's/Temple School of Medicine, Bethlehem, PA
| | - Kelly McCoy
- Department of Dermatology, St. Luke's University Health System, St. Luke's/Temple School of Medicine, Bethlehem, PA
| | - Shaymaa Ashi
- Department of Dermatology, St. Luke's University Health System, St. Luke's/Temple School of Medicine, Bethlehem, PA
| | - Farhaan Hafeez
- Department of Dermatology, St. Luke's University Health System, St. Luke's/Temple School of Medicine, Bethlehem, PA
| |
Collapse
|
6
|
Tsiogka A, Koumaki D, Kyriazopoulou M, Liopyris K, Stratigos A, Gregoriou S. Eccrine Porocarcinoma: A Review of the Literature. Diagnostics (Basel) 2023; 13:diagnostics13081431. [PMID: 37189532 DOI: 10.3390/diagnostics13081431] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/12/2023] [Accepted: 04/14/2023] [Indexed: 05/17/2023] Open
Abstract
Eccrine porocarcinoma (EPC) constitutes a rare malignant adnexal tumor, which accounts for about 0.005-0.01% of all cutaneous malignancies. It may develop de novo or arise from an eccrine poroma, after a latency period of years or even decades. Accumulating data suggest that specific oncogenic drivers and signaling pathways may be implicated in its tumorigenesis, while recent data have demonstrated a high overall mutation rate attributed to UV exposure. Diagnosis may be challenging and should rely on the combination of clinical, dermoscopical, histopathological and immunohistochemical findings. The literature is controversial regarding tumor behavior and prognosis and, therefore, there is no consensus on its surgical management, utility of lymph-node biopsy and further adjuvant or systemic treatment. However, recent advances in tumorigenesis of EPC may aid in the development of novel treatment strategies, which could improve survival of advanced or metastatic disease, such as immunotherapy. This review presents an update of the epidemiology, pathogenesis and clinical presentation of EPC and summarizes current data on diagnostic evaluation and management of this rare cutaneous malignancy.
Collapse
Affiliation(s)
- Aikaterini Tsiogka
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| | - Dimitra Koumaki
- Department of Dermatology, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Maria Kyriazopoulou
- Department of Dermatology and Venereology, 401 General Military Hospital of Athens, 11525 Athens, Greece
| | - Konstantinos Liopyris
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| | - Alexander Stratigos
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| | - Stamatios Gregoriou
- 1st Department of Dermatology-Venereology, Faculty of Medicine, National and Kapodistrian University of Athens, Andreas Sygros Hospital, 16121 Athens, Greece
| |
Collapse
|
7
|
Signorelli C, Zanella‐Cavallero L, Ranucci V, Pellicciotti A, Ruggeri EM. Porocarcinoma of the left arm: A report of a rare skin cancer case and literature review. Clin Case Rep 2022; 10:e05721. [PMID: 35441031 PMCID: PMC9010957 DOI: 10.1002/ccr3.5721] [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: 01/22/2022] [Revised: 03/12/2022] [Accepted: 03/28/2022] [Indexed: 11/07/2022] Open
Abstract
Porocarcinoma is a rare type of skin cancer that develops from the intraepidermal ductal part of eccrine sweat glands. It can arise de novo or from poroma ground with high potential for locoregional metastatic spread, morbidity, and mortality. It mostly occurs in elderly patients.
Collapse
Affiliation(s)
- Carlo Signorelli
- Medical Oncology Unit Belcolle Hospital ASL Viterbo Viterbo Italy
| | | | | | | | | |
Collapse
|
8
|
De Giorgi V, Silvestri F, Savarese I, Venturi F, Scarfì F, Trane L, Bellerba F, Zuccaro B, Maio V, Massi D, Gandini S. Porocarcinoma: an epidemiological, clinical, and dermoscopic 20-year study. Int J Dermatol 2022; 61:1098-1105. [PMID: 35229289 DOI: 10.1111/ijd.16129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/09/2022] [Accepted: 01/11/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Porocarcinoma (PC) is a rare cutaneous adnexal tumor with a variable metastatic potential. Given the paucity of data, guidelines and specific recommendations for PC are not yet well-established. In this study, we evaluate the disease-specific characteristics and outcome of this rare and often underestimated tumor. MATERIALS AND METHOD A retrospective study of the epidemiological, clinical, and dermoscopic characteristics among cases of histopathologically diagnosed PC, collected from the database of two skin cancer clinics in Italy (Firenze, Pistoia) from 2000 to 2020, was conducted. RESULTS Among the 52 patients with 53 tumors, 31 were men (59.6%) and 21 were women (40.4%) with an age range of 49-96 years (median age 82 years). The most common locations were the head/neck region in men (34% in men vs. 17% in women) and the lower limb in women (17% in women vs. 9% in men). Forty-eight cases (91%) underwent local excision. Of these patients, two (4%) experienced local recurrence, and one (2%) developed a second PC on a different anatomical site 1 month after the primary tumor's excision. Lymph node metastases were present in three cases (6%). Two of them have been treated surgically with adjuvant radiotherapy (both are disease-free after a 2-year follow-up period), whereas the third case developed visceral metastases followed by PC-related death. CONCLUSIONS This study, with 52 patients with 53 tumors covering a follow-up period of more than 5 years, shows a less aggressive behavior of PC with 4% local recurrence, 6% nodal metastases, and 2% mortality.
Collapse
Affiliation(s)
- Vincenzo De Giorgi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Flavia Silvestri
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Imma Savarese
- Unit of Dermatology, S. Jacopo Hospital, AUSL Toscana Centro, Pistoia, Italy
| | - Federico Venturi
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Federica Scarfì
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Luciana Trane
- Cancer Research "AttiliaPofferi" Foundation, Pistoia, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| | - Biancamaria Zuccaro
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Vincenza Maio
- Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Daniela Massi
- Section of Pathology, Department of Health Sciences, University of Florence and Histopathology and Molecular Diagnostics, Careggi University Hospital, Florence, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology (IEO), IRCCS, Milan, Italy
| |
Collapse
|
9
|
Treatment of Malignant Adnexal Tumors of the Skin: A 12-Year Perspective. Cancers (Basel) 2022; 14:cancers14040998. [PMID: 35205753 PMCID: PMC8870474 DOI: 10.3390/cancers14040998] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 01/25/2023] Open
Abstract
Malignant adnexal cancers of the skin—extremely rare neoplasms—are mostly reported as non-symptomatic, slow-growing nodules. These carcinomas occur mainly in the middle-aged (50–60 years of age); they are mostly localized on the upper part of the body and are locally aggressive, infiltrate surrounding tissue, and metastasize to regional lymph nodes. The patients’ outcomes depend on multiple prognostic factors, including the size of the primary tumor and its mitotic count. Surgical resection of the primary tumor with or without regional lymph nodes is the treatment method of choice; however, due to aggressive tumor behavior, perioperative treatment may be considered. The role and efficacy of radiotherapy in the treatment of skin adnexal malignancies are not yet fully defined. Some authors suggest that adjuvant radiotherapy may be considered in locally advanced and regional disease. The aim of this study was to evaluate treatment outcomes and assess the efficacy of combined therapy in patients with adnexal malignancies. Our analysis covered all cases of cutaneous adnexal tumor patients diagnosed and provided with multidisciplinary treatment with surgery and radiotherapy since the beginning of 2009.
Collapse
|
10
|
Recent Advances on Immunohistochemistry and Molecular Biology for the Diagnosis of Adnexal Sweat Gland Tumors. Cancers (Basel) 2022; 14:cancers14030476. [PMID: 35158743 PMCID: PMC8833812 DOI: 10.3390/cancers14030476] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Cutaneous sweat gland tumors form an extremely diverse and heterogeneous group of neoplasms that show histological differentiation to the sweat apparatus. Due to their rarity, wide diagnostic range, and significant morphological overlap between entities, their accurate diagnosis remains challenging for pathologists. Until recently, little was known about the molecular pathogenesis of adnexal tumors. Recent findings have revealed a wide range of gene fusions and other oncogenic factors that can be used for diagnostic purposes and, for some, can be detected by immunohistochemistry. Among other organs containing exocrine glands, such as salivary glands, breasts, and bronchi, most of these biomarkers have been reported in homologous neoplasms that share morphological features with their cutaneous counterparts. This review aims to describe these recent molecular and immunohistochemical biomarkers in the field of sweat gland tumors. Abstract Cutaneous sweat gland tumors are a subset of adnexal neoplasms that derive or differentiate into the sweat apparatus. Their great diversity, rarity, and complex terminology make their pathological diagnosis challenging. Recent findings have revealed a wide spectrum of oncogenic drivers, several of which are of diagnostic interest for pathologists. Most of these molecular alterations are represented by gene fusions, which are shared with other homologous neoplasms occurring in organs containing exocrine glands, such as salivary and breast glands, which show similarities to the sweat apparatus. This review aims to provide a synthesis of the most recent immunohistochemical and molecular markers used for the diagnosis of sweat gland tumors and to highlight their relationship with similar tumors in other organs. It will cover adenoid cystic carcinoma (NFIB, MYB, and MYBL1 fusion), cutaneous mixed tumor (PLAG1 fusion), cylindroma and spiradenoma and their carcinomas thereof (NF-κB activation through CYLD inactivation or ALKP1 hotspot mutation), hidradenoma and hidradenocarcinoma (MAML2 fusion), myoepithelioma (EWSR1 and FUS fusion), poroma and porocarcinoma (YAP1, MAML2, and NUTM1 fusion), secretory carcinoma (ETV6, NTRK3 fusion), tubular adenoma and syringo-cystadenoma papilliferum (HRAS and BRAF activating mutations). Sweat gland tumors for which there are no known molecular abnormalities will also be briefly discussed, as well as potential future developments.
Collapse
|
11
|
Westphal D, Garzarolli M, Sergon M, Horak P, Hutter B, Becker JC, Wiegel M, Maczey E, Blum S, Grosche-Schlee S, Rütten A, Ugurel S, Stenzinger A, Glimm H, Aust D, Baretton G, Beissert S, Fröhling S, Redler S, Surowy H, Meier F. High tumour mutational burden and EGFR/MAPK pathway activation are therapeutic targets in metastatic porocarcinoma. Br J Dermatol 2021; 185:1186-1199. [PMID: 34185311 DOI: 10.1111/bjd.20604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Eccrine porocarcinoma (EPC) is a rare skin cancer arising from the eccrine sweat glands. Due to the lack of effective therapies, metastasis is associated with a high mortality rate. OBJECTIVES To investigate the drivers of EPC progression. METHODS We carried out genomic and transcriptomic profiling of metastatic EPC (mEPC), validation of the observed alterations in an EPC patient-derived cell line, confirmation of relevant observations in a large patient cohort of 30 tumour tissues, and successful treatment of a patient with mEPC under the identified treatment regimens. RESULTS mEPC was characterized by a high tumour mutational burden (TMB) with an ultraviolet signature, widespread copy number alterations and gene expression changes that affected cancer-relevant cellular processes such as cell cycle regulation and proliferation, including a pathogenic TP53 (tumour protein 53) mutation, a copy number deletion in the CDKN2A (cyclin dependent kinase inhibitor 2A) region and a CTNND1/PAK1 [catenin delta 1/p21 (RAC1) activated kinase 1] gene fusion. The overexpression of EGFR (epidermal growth factor receptor), PAK1 and MAP2K1 (mitogen-activated protein kinase kinase 1; also known as MEK1) genes translated into strong protein expression and respective pathway activation in the tumour tissue. Furthermore, a patient-derived cell line was sensitive to EGFR and MEK inhibition, confirming the functional relevance of the pathway activation. Immunohistochemistry analyses in a large patient cohort showed the relevance of the observed changes to the pathogenesis of EPC. Our results indicate that mEPC should respond to immune or kinase inhibitor therapy. Indeed, the advanced disease of our index patient was controlled by EGFR-directed therapy and immune checkpoint inhibition for more than 2 years. CONCLUSIONS Molecular profiling demonstrated high TMB and EGFR/MAPK pathway activation to be novel therapeutic targets in mEPC.
Collapse
Affiliation(s)
- D Westphal
- Department of Dermatology, University Hospital Carl Gustav Carus at Technische Universität (TU) Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - M Garzarolli
- Department of Dermatology, University Hospital Carl Gustav Carus at Technische Universität (TU) Dresden, Dresden, Germany
| | - M Sergon
- Institute of Pathology, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany
| | - P Horak
- German Cancer Consortium (DKTK), Heidelberg, Germany.,Division of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and DKFZ, Heidelberg, Germany
| | - B Hutter
- German Cancer Consortium (DKTK), Heidelberg, Germany.,Computational Oncology, Molecular Diagnostics Program, NCT Heidelberg and DKFZ, Heidelberg, Germany.,Division of Applied Bioinformatics, DKFZ, Heidelberg, Germany
| | - J C Becker
- Department of Dermatology, University Hospital Essen, Essen, Germany.,Translational Skin Cancer Research, DKTK, Partner Site Essen, Essen, Germany
| | - M Wiegel
- Department of Dermatology, University Hospital Carl Gustav Carus at Technische Universität (TU) Dresden, Dresden, Germany
| | - E Maczey
- Department of Dermatology, University Medical Center Tübingen, Tübingen, Germany
| | - S Blum
- Institute and Policlinic of Diagnostic and Interventional Radiology, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany
| | - S Grosche-Schlee
- Clinic and Policlinic of Nuclear Medicine, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany
| | - A Rütten
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - A Stenzinger
- German Cancer Consortium (DKTK), Heidelberg, Germany.,Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - H Glimm
- Translational Functional Cancer Genomics, NCT Heidelberg and DKFZ, Heidelberg, Germany.,Department of Translational Medical Oncology NCT Dresden and DKFZ, Dresden, Germany.,Center for Personalized Oncology, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany.,DKTK, Dresden, Germany
| | - D Aust
- National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Institute of Pathology, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany.,Tumor and Normal Tissue Bank of the UCC/NCT Site Dresden, NCT Dresden and University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany
| | - G Baretton
- National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Institute of Pathology, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany.,Tumor and Normal Tissue Bank of the UCC/NCT Site Dresden, NCT Dresden and University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany
| | - S Beissert
- Department of Dermatology, University Hospital Carl Gustav Carus at Technische Universität (TU) Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany
| | - S Fröhling
- German Cancer Consortium (DKTK), Heidelberg, Germany.,Division of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg and DKFZ, Heidelberg, Germany
| | - S Redler
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - H Surowy
- Institute of Human Genetics, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - F Meier
- Department of Dermatology, University Hospital Carl Gustav Carus at Technische Universität (TU) Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT), Dresden, Germany: German Cancer Research Center (DKFZ), Heidelberg, Germany; Faculty of Medicine and University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany; and Helmholtz-Zentrum Dresden-Rossendorf (HZDR), Dresden, Germany.,Skin Cancer Center at the University Cancer Center Dresden, University Hospital Carl Gustav Carus at TU Dresden, Dresden, Germany
| |
Collapse
|