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Jia B, Zhao G, Zhang ZF, Sun BS. Multiple calcifying fibrous tumor of the pleura: A case report. Thorac Cancer 2021; 12:2271-2274. [PMID: 34173725 PMCID: PMC8365007 DOI: 10.1111/1759-7714.14064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/06/2021] [Accepted: 06/11/2021] [Indexed: 12/29/2022] Open
Abstract
Calcifying fibrous tumor of the pleura (CFTP) is a rare benign tumor of the thoracic cavity. Due to the low incidence of CFPT, it is prone to be misdiagnosed because intraoperative analysis of frozen section is a challenge for pathologists. At present, it is difficult to distinguish this tumor from other benign thoracic tumors based on radiographic features. Therefore, surgical resection is the best method for definite diagnosis and treatment.
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Affiliation(s)
- Bin Jia
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, China
| | - Gang Zhao
- Department of Pathology, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China
| | - Zhen-Fa Zhang
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, China
| | - Bing-Sheng Sun
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Cancer Institute and Hospital, Tianjin Medical University, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin, China
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Hernandez M, Lin G, Zhang Y, Rajabnejad A, Balistrieri F, Thistlethwaite P. Multifocal Calcifying Fibrous Tumor at Seven Intrathoracic Sites in One Patient. Ann Thorac Surg 2020; 111:e85-e88. [PMID: 32682754 DOI: 10.1016/j.athoracsur.2020.05.100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/06/2020] [Accepted: 05/10/2020] [Indexed: 11/27/2022]
Abstract
Calcifying fibrous tumors are rare lesions that occur throughout the body. A 35-year-old man presented with exertional dyspnea. Computed tomography showed a polypoid mass abutting pericardium, diaphragm, and left chest wall, and a pleural-based lesion adjacent to T12. Thoracoscopy revealed a large mass with diaphragmatic stalk, two pleural-based nodules, and four diaphragmatic nodules. Pathologic analysis of resected lesions showed calcifying fibrous tumors. Three lesions contained heterogenous mutations associated with this tumor type. The patient is disease free 1 year later. Calcifying fibrous tumors should be recognized as rare multifocal pleural and diaphragmatic-based tumors. Complete resection leads to excellent survival for patients with this uncommon disease.
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Affiliation(s)
- Moises Hernandez
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, California
| | - Grace Lin
- Department of Pathology, University of California, San Diego, La Jolla, California
| | - Yu Zhang
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, California
| | - Ataollah Rajabnejad
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, California
| | - Francesca Balistrieri
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, California
| | - Patricia Thistlethwaite
- Division of Cardiothoracic Surgery, University of California, San Diego, La Jolla, California.
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Massoth LR, Hung YP, Nardi V, Nielsen GP, Hasserjian RP, Louissaint A, Fisch AS, Deshpande V, Zukerberg LR, Lennerz JK, Selig M, Glomski K, Patel PJ, Williams KJ, Sokol ES, Alexander BM, Vergilio JA, Ross JS, Pavlick DC, Chebib I, Williams EA. Pan-sarcoma genomic analysis of KMT2A rearrangements reveals distinct subtypes defined by YAP1-KMT2A-YAP1 and VIM-KMT2A fusions. Mod Pathol 2020; 33:2307-2317. [PMID: 32461620 PMCID: PMC7581494 DOI: 10.1038/s41379-020-0582-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
Sarcomas are driven by diverse pathogenic mechanisms, including gene rearrangements in a subset of cases. Rare soft tissue sarcomas containing KMT2A fusions have recently been reported, characterized by a predilection for young adults, sclerosing epithelioid fibrosarcoma-like morphology, and an often aggressive course. Nonetheless, clinicopathologic and molecular descriptions of KMT2A-rearranged sarcomas remain limited. In this study, we identified by targeted next-generation RNA sequencing an index patient with KMT2A fusion-positive soft tissue sarcoma. In addition, we systematically searched for KMT2A structural variants in a comprehensive genomic profiling database of 14,680 sarcomas interrogated by targeted next-generation DNA and/or RNA sequencing. We characterized the clinicopathologic and molecular features of KMT2A fusion-positive sarcomas, including KMT2A breakpoints, rearrangement partners, and concurrent genetic alterations. Collectively, we identified a cohort of 34 sarcomas with KMT2A fusions (0.2%), and YAP1 was the predominant partner (n = 16 [47%]). Notably, a complex rearrangement with YAP1 consistent with YAP1-KMT2A-YAP1 fusion was detected in most cases, with preservation of KMT2A CxxC-binding domain in the YAP1-KMT2A-YAP1 fusion and concurrent deletions of corresponding exons in KMT2A. The tumors often affected younger adults (age 20-66 [median 40] years) and histologically showed variably monomorphic epithelioid-to-spindle shaped cells embedded in a dense collagenous stroma. Ultrastructural evidence of fibroblastic differentiation was noted in one tumor examined. Our cohort also included two sarcomas with VIM-KMT2A fusions, each harboring concurrent mutations in CTNNB1, SMARCB1, and ARID1A and characterized histologically by sheets of spindle-to-round blue cells. The remaining 16 KMT2A-rearranged sarcomas in our cohort exhibited diverse histologic subtypes, each with unique novel fusion partners. In summary, KMT2A-fusion-positive sarcomas most commonly exhibit sclerosing epithelioid fibrosarcoma-like morphology and complex YAP1-KMT2A-YAP1 fusions. Cases also include rare spindle-to-round cell sarcomas with VIM-KMT2A fusions and tumors of diverse histologic subtypes with unique KMT2A fusions to non-YAP1 non-VIM partners.
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Affiliation(s)
- Lucas R. Massoth
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Yin P. Hung
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Valentina Nardi
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - G. Petur Nielsen
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Robert P. Hasserjian
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Abner Louissaint
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Adam S. Fisch
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Vikram Deshpande
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Lawrence R. Zukerberg
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Jochen K. Lennerz
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Martin Selig
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Krzysztof Glomski
- grid.277313.30000 0001 0626 2712Department of Pathology and Laboratory Medicine, Hartford Hospital, 80 Seymour Street, Hartford, CT 06102 USA
| | - Parth J. Patel
- grid.264727.20000 0001 2248 3398Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140 USA
| | - Kevin Jon Williams
- grid.264727.20000 0001 2248 3398Department of Surgery, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140 USA ,grid.264727.20000 0001 2248 3398Department of Physiology and Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA 19140 USA
| | - Ethan S. Sokol
- grid.418158.10000 0004 0534 4718Foundation Medicine, Inc., 150 Second Street, Cambridge, MA 02141 USA
| | - Brian M. Alexander
- grid.418158.10000 0004 0534 4718Foundation Medicine, Inc., 150 Second Street, Cambridge, MA 02141 USA
| | - Jo-Anne Vergilio
- grid.418158.10000 0004 0534 4718Foundation Medicine, Inc., 150 Second Street, Cambridge, MA 02141 USA
| | - Jeffrey S. Ross
- grid.418158.10000 0004 0534 4718Foundation Medicine, Inc., 150 Second Street, Cambridge, MA 02141 USA ,grid.411023.50000 0000 9159 4457Department of Pathology, State University of New York Upstate Medical University, 766 Irving Avenue, Syracuse, NY 13210 USA
| | - Dean C. Pavlick
- grid.418158.10000 0004 0534 4718Foundation Medicine, Inc., 150 Second Street, Cambridge, MA 02141 USA
| | - Ivan Chebib
- grid.38142.3c000000041936754XDepartment of Pathology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114 USA
| | - Erik A. Williams
- grid.418158.10000 0004 0534 4718Foundation Medicine, Inc., 150 Second Street, Cambridge, MA 02141 USA
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