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Papilloma of the Fallopian Tube: A Rare Gynecologic Neoplasm Harboring a BRAF (c.1799T>A) Mutation (V600E). Int J Gynecol Pathol 2018; 38:459-463. [PMID: 29851866 DOI: 10.1097/pgp.0000000000000526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Papillomas of the fallopian tube are exceedingly rare benign tumors, and only very few cases have been reported in the literature. Clinically, they may present as a mass lesion or occur without symptoms. Histomorphologically, they are papillary tumors covered by nonatypical epithelium with occasional ciliated or goblet cells growing in the lumen, and they are most frequently located in the infundibular region of the fallopian tube. They require a number of differential diagnostic evaluations and can be mistaken for either other benign tumors or malignant neoplasms. Because of their rare occurrence, molecular data about this entity have been lacking so far. Herein, a case of a papilloma with a BRAF (c.1799T>A) mutation (V600E) in a 45-yr-old woman with tumor-like dilation of the fallopian tube is presented.
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Groesser L, Peterhof E, Evert M, Landthaler M, Berneburg M, Hafner C. BRAF and RAS Mutations in Sporadic and Secondary Pyogenic Granuloma. J Invest Dermatol 2016; 136:481-6. [PMID: 26802240 DOI: 10.1038/jid.2015.376] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 09/07/2015] [Accepted: 09/11/2015] [Indexed: 01/13/2023]
Abstract
Pyogenic granuloma (PG) is a common benign vascular skin lesion presenting as a rapidly growing angiomatous papule. The pathogenesis of most sporadic PGs and PGs associated with port wine stains (PWSs) remains elusive. We report that of 10 PGs secondarily arisen on a PWS, 8 showed a BRAF c.1799T>A (p.(Val600Glu)) and 1 a NRAS c.182A>G (p.(Gln61Arg)) mutation. The GNAQ c.548G>A mutation was identified in the PG and in the respective underlying PWS, indicating that PGs originate from cells of the PWS. In contrast to PG, 12 papulonodular lesions, which had developed in the PWSs of seven patients, showed a RAS and BRAF wild-type status. In sporadic PG we identified the BRAF c.1799T>A mutation in 3 of 25, a BRAF c.1391G>A mutation in 1 of 25, and a KRAS c.37G>C mutation in 1 of 25. Mutation-specific immunohistochemical detection of BRAF p.(Val600Glu) confirmed endothelial cells as carriers of the mutation in secondary and sporadic PG. Our study identifies the BRAF c.1799T>A mutation as a major driver mutation in the pathogenesis of, particularly, secondary PG. These data shed light on the hitherto undetermined genetic basis of PG and classify PG as a benign neoplasm.
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Affiliation(s)
- Leopold Groesser
- Department of Dermatology, University of Regensburg, Regensburg, Germany.
| | - Eva Peterhof
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - Matthias Evert
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Michael Landthaler
- Department of Dermatology, University of Regensburg, Regensburg, Germany
| | - Mark Berneburg
- Department of Dermatology, University of Regensburg, Regensburg, Germany
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Shen AS, Peterhof E, Kind P, Rütten A, Zelger B, Landthaler M, Berneburg M, Hafner C, Groesser L. Activating mutations in the RAS/mitogen-activated protein kinase signaling pathway in sporadic trichoblastoma and syringocystadenoma papilliferum. Hum Pathol 2014; 46:272-6. [PMID: 25532942 DOI: 10.1016/j.humpath.2014.11.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 10/24/2014] [Accepted: 11/01/2014] [Indexed: 10/24/2022]
Abstract
Trichoblastoma (TB) and syringocystadenoma papilliferum (SCAP) are both rare adnexal skin lesions occurring either sporadically or as secondary neoplasms in sebaceous nevi. TB and SCAP associated with sebaceous nevi have been shown to carry the same HRAS mutation as the underlying nevus. However, the genetic background of sporadic TB and SCAP has remained unknown. Therefore, we screened 18 sporadic TBs and 23 sporadic syringocystadenoma papillifera from 41 patients for the presence of activating mutations in RAS genes and other oncogenes. Using a RAS SNaPshot assay, HRAS mutations were detected in 2 (11%) of 18 sporadic TB and 6 (26%) of 23 sporadic syringocystadenoma papillifera. A KRAS mutation was identified in 1 sporadic SCAP. High-throughput oncogene mutation profiling furthermore identified BRAF V600E mutations in sporadic syringocystadenoma papillifera, which could be validated in 12 (52%) of 23 lesions using a BRAF SNaPshot assay. BRAF and RAS mutations were mutually exclusive in sporadic syringocystadenoma papillifera. No BRAF mutation could be detected in 3 syringocystadenoma papillifera secondarily arisen from a sebaceous nevus as well as in sporadic TB. In 14 lesions carrying an oncogenic mutation, nonlesional control tissue from the epidermal margin revealed a wild-type sequence, thus proving the somatic character of the mutation. Our results indicate that activation of the RAS-mitogen-activated protein kinase pathway by BRAF and RAS mutations contributes significantly to the tumorigenesis of sporadic SCAP and, less frequently, of sporadic TB.
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Affiliation(s)
- Anne-Sophie Shen
- Department of Dermatology, University of Regensburg, 93053 Regensburg, Germany
| | - Eva Peterhof
- Department of Dermatology, University of Regensburg, 93053 Regensburg, Germany
| | - Peter Kind
- Dermatohistological Laboratory Prof. Kind, 63065 Offenbach, Germany
| | - Arno Rütten
- Dermatopathology Friedrichshafen, 88048 Friedrichshafen, Germany
| | - Bernhard Zelger
- Department of Dermatology and Venerology, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Michael Landthaler
- Department of Dermatology, University of Regensburg, 93053 Regensburg, Germany
| | - Mark Berneburg
- Department of Dermatology, University of Regensburg, 93053 Regensburg, Germany
| | - Christian Hafner
- Department of Dermatology, University of Regensburg, 93053 Regensburg, Germany; Dermatohistological Laboratory, Sonnenstr. 7, 80331 Munich, Germany
| | - Leopold Groesser
- Department of Dermatology, University of Regensburg, 93053 Regensburg, Germany.
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Venesio T, Balsamo A, Errichiello E, Ranzani GN, Risio M. Oxidative DNA damage drives carcinogenesis in MUTYH-associated-polyposis by specific mutations of mitochondrial and MAPK genes. Mod Pathol 2013; 26:1371-81. [PMID: 23599153 DOI: 10.1038/modpathol.2013.66] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2012] [Revised: 01/28/2013] [Accepted: 01/28/2013] [Indexed: 12/29/2022]
Abstract
MUTYH is a DNA-base-excision-repair gene implicated in the activation of nuclear and mitochondrial cell-death pathways. MUTYH germline mutations cause an inherited polyposis, MUTYH-associated-polyposis, characterized by multiple adenomas and increased susceptibility to colorectal cancer. Since this carcinogenesis remains partially unknown, we searched for nuclear and mitochondrial gene alterations that may drive the tumorigenic process. Ninety-six adenomas and 7 carcinomas from 12 MUTYH-associated-polyposis and 13 classical/attenuated adenomatous polyposis patients were investigated by sequencing and pyrosequencing for the presence of mutations in KRAS, BRAF, MT-CO1/MT-CO2 and MT-TD genes. KRAS mutations were identified in 24% MUTYH-associated-polyposis vs 15% classical/attenuated familial polyposis adenomas; mutated MUTYH-associated-polyposis adenomas exhibited only c.34G>T transversions in codon 12, an alteration typically associated with oxidative DNA damage, or mutations in codon 13; neither of these mutations was found in classical/attenuated familial polyposis adenomas (P<0.001). Mutated MUTYH-associated-polyposis carcinomas showed KRAS c.34G>T transversions, prevalently occurring with BRAFV600E; none of the classical/attenuated familial polyposis carcinomas displayed these alterations. Comparing mitochondrial DNA from lymphocytes and adenomas of the same individuals, we detected variants in 82% MUTYH-associated-polyposis vs 38% classical/attenuated familial polyposis patients (P=0.040). MT-CO1/MT-CO2 missense mutations, which cause aminoacid changes, were only found in MUTYH-associated-polyposis lesions and were significantly associated with KRAS mutations (P=0.0085). We provide evidence that MUTYH-associated-polyposis carcinogenesis is characterized by the occurrence of specific mutations in both KRAS and phylogenetically conserved genes of mitochondrial DNA which are involved in controlling oxidative phosphorylation; this implies the existence of a colorectal tumorigenesis in which changes in mitochondrial functions cooperate with RAS-induced malignant transformation.
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Affiliation(s)
- Tiziana Venesio
- Unit of Pathology, Institute for Cancer Research and Treatment, Candiolo, (Torino), Italy
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Ponti G, Pellacani G, Seidenari S, Pollio A, Muscatello U, Tomasi A. Cancer-associated genodermatoses: Skin neoplasms as clues to hereditary tumor syndromes. Crit Rev Oncol Hematol 2013; 85:239-56. [DOI: 10.1016/j.critrevonc.2012.07.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 06/24/2012] [Accepted: 07/03/2012] [Indexed: 12/17/2022] Open
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Considerations on the Performance of Immunohistochemistry for Mismatch Repair Gene Proteins in Cases of Sebaceous Neoplasms and Keratoacanthomas With Reference to Muir–Torre Syndrome. Am J Dermatopathol 2012; 34:416-22. [DOI: 10.1097/dad.0b013e3182226a28] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Nielsen M, Morreau H, Vasen HFA, Hes FJ. MUTYH-associated polyposis (MAP). Crit Rev Oncol Hematol 2010; 79:1-16. [PMID: 20663686 DOI: 10.1016/j.critrevonc.2010.05.011] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 05/11/2010] [Accepted: 05/27/2010] [Indexed: 12/13/2022] Open
Abstract
The human mutY homologue (MUTYH) gene is responsible for inheritable polyposis and colorectal cancer. This review discusses the molecular genetic aspects of the MUTYH gene and protein, the clinical impact of mono- and biallelic MUTYH mutations and histological aspects of the MUTYH tumors. Furthermore, the relationship between MUTYH and the mismatch repair genes in colorectal cancer (CRC) families is examined. Finally, the role of other base excision repair genes in polyposis and CRC patients is discussed.
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Affiliation(s)
- Maartje Nielsen
- Department Clinical Genetics, Leiden University Medical Centre, Albinusdreef, Leiden, The Netherlands.
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Shalin SC, Lyle S, Calonje E, Lazar AJF. Sebaceous neoplasia and the Muir-Torre syndrome: important connections with clinical implications. Histopathology 2010; 56:133-47. [PMID: 20055911 DOI: 10.1111/j.1365-2559.2009.03454.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Sebaceous neoplasia comprises a spectrum ranging from benign to malignant. Proper histological identification is important for treatment, prognosis and potential association with the Muir-Torre syndrome (MTS). Our increased understanding of the significance and pathogenesis of these tumours has led to improved risk stratification, screening recommendations, and treatment of patients with an initial presentation of a sebaceous tumour. This review focuses on the diagnostic and histological features of sebaceous lesions, the MTS, and recent insights into the molecular pathogenesis of sebaceous tumours.
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Affiliation(s)
- Sara C Shalin
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
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Abstract
MUTYH-associated polyposis (MAP) is an autosomal recessive disorder characterised by adenomatous polyps of the colorectum and a very high risk of colorectal cancer. It appears to be at least as prevalent as autosomal dominant familial adenomatous polyposis (that is caused by truncating mutations in the APC gene) with which it shares important gastroenterological features. It was first recognised as recently as 2002 and its full phenotype and natural history are still being characterised. Key extracolonic manifestations include a predisposition to duodenal adenomas and cancer and a modest increase in risk for several extraintestinal tumours. Testing for mutations in the MUTYH gene is indicated in patients who have multiple colorectal adenomas or a family history suggestive of autosomal recessive colorectal cancer and for the siblings and spouses of patients with MAP in order to inform surveillance and treatment for patients and their families.
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Affiliation(s)
- Julian R Sampson
- Institute of Medical Genetics, School of Medicine, Cardiff University, Heath Park, Cardiff CF14 4XN, UK.
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Lindor NM. Hereditary colorectal cancer: MYH-associated polyposis and other newly identified disorders. Best Pract Res Clin Gastroenterol 2009; 23:75-87. [PMID: 19258188 DOI: 10.1016/j.bpg.2008.11.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Historically, discussions of familial adenomatous polyposis and hereditary non-polyposis colon cancer have dominated lectures and writings on hereditary predisposition to colorectal cancer. In the last decade, the subject has grown well beyond the two entities. In this paper, five topics relevant to genetic risk assessment for colorectal cancer are reviewed. These include the autosomal recessive MYH-associated polyposis, hyperplastic polyposis and serrated pathway syndrome, the association of autosomal dominant juvenile polyposis with hereditary hemorrhagic telangiectasia, familial colorectal cancer type X, and the syndrome of biallelic DNA mismatch repair gene mutations. Knowledge of these entities may assist clinicians to recognize and manage cases that do not fit into the more common syndromes of colorectal cancer predisposition.
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Affiliation(s)
- Noralane M Lindor
- Department of Medical Genetics, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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