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Baumhoer D, Hench J, Amary F. Recent advances in molecular profiling of bone and soft tissue tumors. Skeletal Radiol 2024; 53:1925-1936. [PMID: 38231260 PMCID: PMC11303483 DOI: 10.1007/s00256-024-04584-9] [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: 11/23/2023] [Revised: 01/08/2024] [Accepted: 01/08/2024] [Indexed: 01/18/2024]
Abstract
The molecular characterization of soft tissue and bone tumors is a rapidly evolving field that has changed the perspective of how these tumors are diagnosed today. Morphology and clinico-radiological context still represent the cornerstone of diagnostic considerations but are increasingly complemented by molecular data that aid in objectifying and confirming the classification. The spectrum of analyses comprises mutation or gene fusion specific immunohistochemical antibodies, fluorescence in situ hybridization, DNA and RNA sequencing as well as CpG methylation profiling. This article provides an overview of which tools are presently available to characterize bone and soft tissue neoplasms molecularly, what limitations should be considered, and what conclusions can be drawn from the individual findings.
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Affiliation(s)
- D Baumhoer
- Bone Tumor and DOESAK Reference Center, Institute of Medical Genetics and Pathology, University Hospital and University of Basel, Schoenbeinstrasse 40, 4031, Basel, Switzerland.
| | - J Hench
- Institute of Medical Genetics and Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - F Amary
- Department of Histopathology, Royal National Orthopaedic Hospital, Greater London, Stanmore, UK
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Oya K, Takeshita A, Wakamori K, Song M, Kimura H, Hirose K, Shimamoto H, Sato S, Matsunaga K, Uzawa N, Toyosawa S. Recurrent cementoblastoma with multifocal growth and cellular atypia: a case report. Diagn Pathol 2024; 19:57. [PMID: 38589906 PMCID: PMC11000364 DOI: 10.1186/s13000-024-01479-0] [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: 01/09/2024] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND Cementoblastoma is a rare odontogenic tumor characterized by the formation of osteocementum-like tissue on a tooth root directly by neoplastic cementoblasts. Although it is categorized as benign, it has a high potential for growth with a certain degree of recurrence risk. However, there are only a few studies describing the features of recurrent cementoblastoma. The diagnosis of recurrent cementoblastoma is challenging not only due to its cytological atypia but also because of its large size and multicentric growth pattern. These characteristics suggest a potential for malignancy. CASE PRESENTATION A 29-year-old woman was transferred to our university dental hospital complaining of swelling of the right mandible. She had a history of enucleation of cementoblastoma associated with the third molar of the right mandible. Five years after the initial treatment, imaging demonstrated well-circumscribed multicentric radiopaque lesions in the same area. Histologically, the lesion consisted of osteocementum-like tissue rimmed with polygonal or plump tumor cells. Several cells were large epithelioid cells with bizarre nucleoli, which may be reminiscent of malignant tumors. Otherwise, there were no apparent malignant findings, including proliferative activity or atypical mitotic figure. Besides, tumor cells were positive for c-FOS, a marker of osteoblastoma and cementoblastoma. Eventually, the patient was diagnosed with recurrent cementoblastoma. CONCLUSIONS Pathological analyses of this case suggested that the recurrent event in the cementoblastoma altered its growth pattern and tumor cell shape. Moreover, in the case of enucleation surgery, long-term follow-up is important because there is some recurrent risk of cementoblastoma, although it is not high.
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Affiliation(s)
- Kaori Oya
- Division of Clinical Laboratory, Osaka University Dental Hospital, Suita, Osaka, Japan
| | - Akinori Takeshita
- Department of Oral and Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kanta Wakamori
- Department of Oral and Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Misa Song
- Department of Diagnostic Pathology, Itami City Hospital, Itami, Hyogo, Japan
| | - Hayato Kimura
- Department of Diagnostic Pathology, Itami City Hospital, Itami, Hyogo, Japan
| | - Katsutoshi Hirose
- Department of Oral and Maxillofacial Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hiroaki Shimamoto
- Department of Oral and Maxillofacial Radiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Sunao Sato
- Department of Oral and Maxillofacial Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Kazuhide Matsunaga
- Department of Oral and Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Narikazu Uzawa
- Department of Oral and Maxillofacial Oncology and Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Satoru Toyosawa
- Division of Clinical Laboratory, Osaka University Dental Hospital, Suita, Osaka, Japan.
- Department of Oral and Maxillofacial Pathology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan.
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Yamaga K, Kuwamoto S, Tanishima S, Yamashita H, Asano N, Matsushita M, Akahori K, Osaki M, Hisaoka M, Nagashima H. An unresectable osteoblastoma of the axis controlled with denosumab. J Orthop Sci 2024; 29:379-383. [PMID: 35469739 DOI: 10.1016/j.jos.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 01/10/2022] [Accepted: 02/14/2022] [Indexed: 02/09/2023]
Affiliation(s)
- Kensaku Yamaga
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan.
| | - Satoshi Kuwamoto
- Department of Pathology, Tottori University Hospital, Yonago, Tottori, Japan
| | - Shinji Tanishima
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | | | - Naofumi Asano
- Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Michiko Matsushita
- Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Keiichi Akahori
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Mari Osaki
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
| | - Masanori Hisaoka
- Department of Pathology and Oncology, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Hideki Nagashima
- Division of Orthopedic Surgery, Department of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago, Tottori, Japan
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Schulte M, Hartmann W. [Bone tumors in children and adolescents]. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:348-356. [PMID: 37828376 DOI: 10.1007/s00292-023-01235-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
Osseous lesions are rare; however, their incidence is increased in childhood and adolescence. The spectrum of osseous processes in this age group is limited, with benign lesions being much more prevalent than malignant tumors. For the differential diagnosis, it is essential to have in-depth knowledge of the more frequent bone diseases in children and adolescents. The current review presents these diseases based on the morphologic approach of the WHO classification, including giant cell-rich and cystic lesions, chondrogenic and bone-forming lesions [7]. Small round cell sarcomas which are now summarized in a separate chapter of the WHO classification have been described previously [12, 20].
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Affiliation(s)
- Miriam Schulte
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude D17, 48149, Münster, Deutschland.
| | - Wolfgang Hartmann
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, Gebäude D17, 48149, Münster, Deutschland.
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Abstract
FOS and FOSB proto-oncogens are involved in a wide variety of tumourigenic processes. FOS and FOSB gene rearrangements are observed in epithelioid haemangioma, pseudomyogenic haemangioendothelioma, osteoid osteoma/osteoblastoma/cementoblastoma and proliferative myositis/fasciitis. In this review, we provide an overview of FOS and FOSB, including their functions and the differences between lesions with known FOS/FOSB gene rearrangements. Additionally, we discuss the use of FOS/FOSB immunohistochemistry as a diagnostic tool for these lesions.
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Affiliation(s)
- Fleur Cordier
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent, Belgium
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Blackburn PR, Douglass DP, Ramakrishnaiah RH, Montgomery CO, Shi Z, Wheeler DA, Koo SC. Neonatal osteoblastic tumor with a novel PTBP1::FOSB fusion. Genes Chromosomes Cancer 2023; 62:611-616. [PMID: 37132513 DOI: 10.1002/gcc.23149] [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: 01/27/2023] [Revised: 04/18/2023] [Accepted: 04/24/2023] [Indexed: 05/04/2023] Open
Abstract
Congenital/neonatal bone neoplasms are extremely rare. We present the case of a patient with a neonatal bone tumor of the fibula that had osteoblastic differentiation and a novel PTBP1::FOSB fusion. FOSB fusions are described in several different tumor types, including osteoid osteoma and osteoblastoma; however, these tumors typically present in the second or third decade of life, with case reports as young as 4 months of age. Our case expands the spectrum of congenital/neonatal bone lesions. The initial radiologic, histologic, and molecular findings supported the decision for close clinical follow-up rather than more aggressive intervention. Since the time of diagnosis, this tumor has undergone radiologic regression without treatment.
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Affiliation(s)
- Patrick R Blackburn
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - David P Douglass
- Department of Pediatrics, Hematology/Oncology Section, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Raghu H Ramakrishnaiah
- Department of Pediatric Radiology, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Corey O Montgomery
- Department of Orthopedics, Arkansas Children's Hospital, Little Rock, Arkansas, USA
| | - Zonggao Shi
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - David A Wheeler
- Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Selene C Koo
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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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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Al-Dasuqi K, Cheng R, Moran J, Irshaid L, Maloney E, Porrino J. Update of pediatric bone tumors: osteogenic tumors and osteoclastic giant cell-rich tumors. Skeletal Radiol 2023; 52:671-685. [PMID: 36326880 DOI: 10.1007/s00256-022-04221-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022]
Abstract
There are numerous bone tumors in the pediatric population, with imaging playing an essential role in diagnosis and management. Our understanding of certain bone tumors has rapidly evolved over the past decade with advancements in next-generation genetic sequencing techniques. This increased level of understanding has altered the nomenclature, management approach, and prognosis of certain lesions. We provide a detailed update of bone tumors that occur in the pediatric population with emphasis on the recently released nomenclature provided in the 5th edition of the World Health Organization Classification of Soft Tissue and Bone Tumours.
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Affiliation(s)
- Khalid Al-Dasuqi
- Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Ryan Cheng
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Jay Moran
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Lina Irshaid
- Pathology Associates at Beverly Hospital, 85 Herrick Street, Beverly, MA, 01915, USA
| | - Ezekiel Maloney
- Seattle Children's Hospital, 4800 Sand Point Way NE, Seattle, WA, 98105, USA
| | - Jack Porrino
- Yale Radiology and Biomedical Imaging, 330 Cedar Street, New Haven, CT, 06520, USA.
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Meyer J, Priemel M, Rolvien T, Frosch KH, Schlickewei C, Yarar-Schlickewei S. The Diagnostic Challenge of Osteoid Osteoma in the Bones of the Hand—A Case Series. Diagnostics (Basel) 2023; 13:diagnostics13071279. [PMID: 37046495 PMCID: PMC10093072 DOI: 10.3390/diagnostics13071279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/04/2023] [Accepted: 03/10/2023] [Indexed: 03/31/2023] Open
Abstract
Osteoid osteoma (OO) is a benign bone tumor that rarely occurs in the bones of the hand. Due to the comparatively non-specific symptoms when occurring in the hand, OO is often misdiagnosed at first presentation, posing a diagnostic challenge. In the present case study, six cases of phalangeal and carpal OO, treated surgically at our department between 2006 and 2020, were retrospectively reviewed. We compared all cases regarding demographic data, clinical presentation, imaging findings, time to diagnosis, surgical treatment, and clinical outcome in follow-up examinations. When OO occurs in the bones of the hand, it can lead to swelling and deformities, such as enlargement of the affected bone and nail hypertrophy. Initial misdiagnoses such as primary bone tumors other than OO, tendinitis, osteomyelitis, or arthritis are common. Most of the presented cases showed a prolonged time until diagnosis, whereby the primarily performed imaging modality was often not sensitive. CT proved to be the most sensitive sectional imaging modality for diagnosing OO. With adequate surgical treatment, complications and recurrence are rare.
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10
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De Noon S, Piggott R, Trotman J, Tadross JA, Fittall M, Hughes D, Ye H, Munasinghe E, Murray M, Tirabosco R, Amary F, Coleman N, Watkins J, Hubank M, Tarpey P, Behjati S, Flanagan AM. Recurrent FOSL1 rearrangements in desmoplastic fibroblastoma. J Pathol 2023; 259:119-124. [PMID: 36426824 PMCID: PMC10107450 DOI: 10.1002/path.6038] [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: 09/23/2022] [Revised: 11/02/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
The FOS gene family has been implicated in tumourigenesis across several tumour types, particularly mesenchymal tumours. The rare fibrous tumour desmoplastic fibroblastoma is characterised by overexpression of FOSL1. However, previous studies using cytogenetic and molecular techniques did not identify an underlying somatic change involving the FOSL1 gene to explain this finding. Prompted by an unusual index case, we report the discovery of a novel FOSL1 rearrangement in desmoplastic fibroblastoma using whole-genome and targeted RNA sequencing. We investigated 15 desmoplastic fibroblastomas and 15 fibromas of tendon sheath using immunohistochemistry, in situ hybridisation and targeted RNA sequencing. Rearrangements in FOSL1 and FOS were identified in 10/15 and 2/15 desmoplastic fibroblastomas respectively, which mirrors the pattern of FOS rearrangements observed in benign bone and vascular tumours. Fibroma of tendon sheath, which shares histological features with desmoplastic fibroblastoma, harboured USP6 rearrangements in 9/15 cases and did not demonstrate rearrangements in any of the four FOS genes. The overall concordance between FOSL1 immunohistochemistry and RNA sequencing results was 90%. These findings illustrate that FOSL1 and FOS rearrangements are a recurrent event in desmoplastic fibroblastoma, establishing this finding as a useful diagnostic adjunct and expanding the spectrum of tumours driven by FOS gene family alterations. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Solange De Noon
- Research Department of PathologyUniversity College London Cancer InstituteLondonUK
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Robert Piggott
- Cambridge Genomics LaboratoryCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Jamie Trotman
- Cambridge Genomics LaboratoryCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - John A Tadross
- Cambridge Genomics LaboratoryCambridge University Hospitals NHS Foundation TrustCambridgeUK
- Department of HistopathologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
- MRC Metabolic Diseases Unit, Wellcome Trust‐Medical Research Council Institute of Metabolic ScienceUniversity of CambridgeCambridgeUK
| | - Matthew Fittall
- Department of OncologyUniversity College London Hospitals NHS Foundation TrustLondonUK
- Division of OncologyUniversity College London Cancer InstituteLondonUK
| | - Debbie Hughes
- Paediatric Tumour Biology, Division of Clinical StudiesThe Institute of Cancer ResearchLondonUK
| | - Hongtao Ye
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Emani Munasinghe
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Matthew Murray
- Department of Paediatric Haematology and OncologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
- Department of PathologyUniversity of CambridgeCambridgeUK
| | - Roberto Tirabosco
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | - Fernanda Amary
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
| | | | - James Watkins
- Cambridge Genomics LaboratoryCambridge University Hospitals NHS Foundation TrustCambridgeUK
- Department of HistopathologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Michael Hubank
- Clinical GenomicsThe Royal Marsden NHS Foundation TrustLondonUK
- Molecular PathologyThe Institute of Cancer ResearchLondonUK
| | - Patrick Tarpey
- Cambridge Genomics LaboratoryCambridge University Hospitals NHS Foundation TrustCambridgeUK
| | - Sam Behjati
- Department of Paediatric Haematology and OncologyCambridge University Hospitals NHS Foundation TrustCambridgeUK
- Cellular GeneticsWellcome Sanger InstituteHinxtonUK
- Department of PaediatricsUniversity of CambridgeCambridgeUK
| | - Adrienne M Flanagan
- Research Department of PathologyUniversity College London Cancer InstituteLondonUK
- Department of HistopathologyRoyal National Orthopaedic HospitalStanmoreUK
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Zhao F, Zhang X, Pan Q, Ye X, Yu M, Li Z, Wang H. Temporal bone osteoblastoma involving temporomandibular joint diagnosed as simple disc disorders: A case report. Front Surg 2023; 9:1033342. [PMID: 36684216 PMCID: PMC9852635 DOI: 10.3389/fsurg.2022.1033342] [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: 08/31/2022] [Accepted: 10/26/2022] [Indexed: 01/07/2023] Open
Abstract
Background Osteoblastoma is quite rare in the oromaxillo-facial region, while the mandible is always the predilection. However, in our case, the lesion was located in the left temporal articular tubercle, involving the adjacent skull base, which is extremely rare in the literature. Case reports It had been diagnosed as the most common temporomandibular joint disorder in the local hospital before the patient came to our department, mainly due to the primary symptom, that was, the patient got pain in the left temporomandibular joint area while opening the mouth. However, we found a mass of bone lesions at the left temporal articular tubercle in MRI and cone beam CT, and it turned out to be an osteoblastoma after surgery. The patient's primary symptom disappeared after recovering from the surgery, and there have been no indications of complication or recurrence up to now. Conclusion Osteoblastoma is very rare in the temporomandibular joint region. It could easily miss the possibility of a benign tumor due to its unusual location and confusing chief complaint in this case. Our report provides experience in the identification of osteoblastoma in rare sites.
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Yasir M, Park J, Han ET, Park WS, Han JH, Kwon YS, Lee HJ, Hassan M, Kloczkowski A, Chun W. Exploration of Flavonoids as Lead Compounds against Ewing Sarcoma through Molecular Docking, Pharmacogenomics Analysis, and Molecular Dynamics Simulations. MOLECULES (BASEL, SWITZERLAND) 2023; 28:molecules28010414. [PMID: 36615603 PMCID: PMC9823950 DOI: 10.3390/molecules28010414] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/28/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023]
Abstract
Ewing sarcoma (ES) is a highly malignant carcinoma prevalent in children and most frequent in the second decade of life. It mostly occurs due to t(11;22) (q24;q12) translocation. This translocation encodes the oncogenic fusion protein EWS/FLI (Friend leukemia integration 1 transcription factor), which acts as an aberrant transcription factor to deregulate target genes essential for cancer. Traditionally, flavonoids from plants have been investigated against viral and cancerous diseases and have shown some promising results to combat these disorders. In the current study, representative flavonoid compounds from various subclasses are selected and used to disrupt the RNA-binding motif of EWS, which is required for EWS/FLI fusion. By blocking the RNA-binding motif of EWS, it might be possible to combat ES. Therefore, molecular docking experiments validated the binding interaction patterns and structural behaviors of screened flavonoid compounds within the active region of the Ewing sarcoma protein (EWS). Furthermore, pharmacogenomics analysis was used to investigate potential drug interactions with Ewing sarcoma-associated genes. Finally, molecular dynamics simulations were used to investigate the stability of the best selected docked complexes. Taken together, daidzein, kaempferol, and genistein exhibited a result comparable to ifosfamide in the proposed in silico study and can be further analyzed as possible candidate compounds in biological in vitro studies against ES.
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Affiliation(s)
- Muhammad Yasir
- Department of Pharmacology, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Jinyoung Park
- Department of Pharmacology, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Eun-Taek Han
- Department of Medical Environmental Biology and Tropical Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Won Sun Park
- Department of Physiology, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Jin-Hee Han
- Department of Medical Environmental Biology and Tropical Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Yong-Soo Kwon
- College of Pharmacy, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Hee-Jae Lee
- Department of Pharmacology, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
| | - Mubashir Hassan
- The Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Andrzej Kloczkowski
- The Steve and Cindy Rasmussen Institute for Genomic Medicine at Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Wanjoo Chun
- Department of Pharmacology, Kangwon National University School of Medicine, Chuncheon 24341, Republic of Korea
- Correspondence: ; Tel.: +82-33-250-8853
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Toland AMS, Lam SW, Varma S, Wang A, Howitt BE, Kunder CA, Kerr DA, Szuhai K, Bovée JVMG, Charville GW. GRM1 Immunohistochemistry Distinguishes Chondromyxoid Fibroma From its Histologic Mimics. Am J Surg Pathol 2022; 46:1407-1414. [PMID: 35650682 PMCID: PMC9481662 DOI: 10.1097/pas.0000000000001921] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Chondromyxoid fibroma (CMF) is a rare benign bone neoplasm that manifests histologically as a lobular proliferation of stellate to spindle-shaped cells in a myxoid background, exhibiting morphologic overlap with other cartilaginous and myxoid tumors of bone. CMF is characterized by recurrent genetic rearrangements that place the glutamate receptor gene GRM1 under the regulatory control of a constitutively active promoter, leading to increased gene expression. Here, we explore the diagnostic utility of GRM1 immunohistochemistry as a surrogate marker for GRM1 rearrangement using a commercially available monoclonal antibody in a study of 230 tumors, including 30 CMF cases represented by 35 specimens. GRM1 was positive by immunohistochemistry in 97% of CMF specimens (34/35), exhibiting moderate to strong staining in more than 50% of neoplastic cells; staining was diffuse (>95% of cells) in 25 specimens (71%). Among the 9 CMF specimens with documented exposure to acid decalcification, 4 (44%) exhibited diffuse immunoreactivity (>95%) for GRM1, whereas all 15 CMF specimens (100%) with lack of exposure to decalcification reagents were diffusely immunoreactive ( P =0.003). High GRM1 expression at the RNA level was previously observed by quantitative reverse transcription polymerase chain reaction in 9 CMF cases that were also positive by immunohistochemistry; low GRM1 expression was observed by quantitative reverse transcription polymerase chain reaction in the single case of CMF that was negative by immunohistochemistry. GRM1 immunohistochemistry was negative (<5%) in histologic mimics of CMF, including conventional chondrosarcoma, enchondroma, chondroblastoma, clear cell chondrosarcoma, giant cell tumor of the bone, fibrous dysplasia, chondroblastic osteosarcoma, myoepithelial tumor, primary aneurysmal bone cyst, brown tumor, phosphaturic mesenchymal tumor, CMF-like osteosarcoma, and extraskeletal myxoid chondrosarcoma. These results indicate that GRM1 immunohistochemistry may have utility in distinguishing CMF from its histologic mimics.
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Affiliation(s)
- Angus M. S. Toland
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Suk Wai Lam
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sushama Varma
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Aihui Wang
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Brooke E. Howitt
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Christian A. Kunder
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
| | - Darcy A. Kerr
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Karoly Szuhai
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Gregory W. Charville
- Department of Pathology, Stanford University School of Medicine, Stanford, California, USA
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14
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Hesni S, Lindsay D, Saifuddin A. Test Yourself Answer: A 22-year-old female with a 2-year history of progressive right lower back pain. Skeletal Radiol 2022; 51:2069-2070. [PMID: 35274179 DOI: 10.1007/s00256-022-04030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Susan Hesni
- Department of Radiology, Royal National Orthopaedic Hospital (RNOH), Brockley Hill, Stanmore, HA7 4LP, UK.
| | - Daniel Lindsay
- Department of Histopathology, Royal National Orthopaedic Hospital (RNOH), Stanmore, UK
| | - Asif Saifuddin
- Department of Radiology, Royal National Orthopaedic Hospital (RNOH), Brockley Hill, Stanmore, HA7 4LP, UK
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15
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Vargas AC, Ma L, Talbot J, Gill AJ, Maclean FM. Preliminary exploration of the role of FOS immunohistochemistry in proliferative fasciitis and myositis. Histopathology 2022; 81:414-417. [PMID: 35778268 DOI: 10.1111/his.14716] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Ana Cristina Vargas
- Douglass Hanly Moir Pathology Macquarie Park.,Sydney Medical School, University of Sydney.,Cancer Diagnosis and Pathology Group Kolling Institute of Medical Research Royal North Shore Hospital, St Leonards
| | - Leanne Ma
- Douglass Hanly Moir Pathology Macquarie Park
| | - Joel Talbot
- Douglass Hanly Moir Pathology Macquarie Park
| | - Anthony J Gill
- Sydney Medical School, University of Sydney.,Cancer Diagnosis and Pathology Group Kolling Institute of Medical Research Royal North Shore Hospital, St Leonards.,Department of Anatomical Pathology NSW Health Pathology, Royal North Shore Hospital, Sydney
| | - Fiona M Maclean
- Douglass Hanly Moir Pathology Macquarie Park.,Cancer Diagnosis and Pathology Group Kolling Institute of Medical Research Royal North Shore Hospital, St Leonards.,Faculty of Medicine and Health Sciences Macquarie University, North Ryde
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16
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Hartmann W, Hardes J, Vieth V. [Bone tumours-What's new in the 2020 WHO classification and beyond]. PATHOLOGIE (HEIDELBERG, GERMANY) 2022; 43:319-329. [PMID: 35925224 DOI: 10.1007/s00292-022-01079-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/05/2022] [Indexed: 06/15/2023]
Abstract
The recent WHO classification of Bone Tumours (2020) has introduced several changes. Conceptionally, small round cell sarcomas are now summarized in a distinct chapter, acknowledging their occurrence in both, bone and soft tissue. In the light of new molecular findings some diagnostic categories, such as fibrohistiocytic tumors, have been abandoned, and a few new entities have been added to the classification. Finally, systematic changes were made with regard to the terminology employed in the classification of chondrogenic tumours, and modifications have been made with respect to the biological potential of some lesions. This article summarizes the major changes made, underscoring the elementary role of an interdisciplinary approach in the diagnosis and management of bone lesions.
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Affiliation(s)
- Wolfgang Hartmann
- Sektion für Translationale Pathologie, Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
| | - Jendrik Hardes
- Klinik für Tumororthopädie, Universitätsklinikum Essen, Hufelandstraße 55, 45147, Essen, Deutschland
| | - Volker Vieth
- Klinik für Radiologie, Klinikum Ibbenbüren, Große Straße 41, 4947, Ibbenbüren, Deutschland
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17
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Tsui KY, Maclean F, Moir D, Cheah A, Bonar F, Tabot J, Gill AJ, Vargas AC. Immunohistochemistry for FOSB and FOS is a Useful Ancillary Tool in the Diagnosis of Epithelioid Hemangioma but There are Pitfalls in Interpretation Including Expression in Other Vascular Lesions. Int J Surg Pathol 2022; 31:280-288. [PMID: 35635207 DOI: 10.1177/10668969221101867] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Introduction: Epithelioid hemangioma is a benign vascular neoplasm associated with FOS and/or FOSB protein overexpression detected by immunohistochemistry (IHC). Methods: The aim of our study was to determine the co-expression or independent IHC expression of FOS and FOSB in a cohort of epithelioid hemangiomas. We also included two cohorts of other vascular lesions: papillary endothelial hyperplasia and lobular capillary hemangioma / pyogenic granuloma. Results: We identified 50 cases of epithelioid hemangioma, 84% of which were cutaneous and the remaining involved other anatomic locations. Over two thirds of all cases expressed FOSB (68%; 34/50) while FOS immunoreactivity was identified in 46% of all cases. Co-expression of FOSB and FOS occurred in 37% of cases while 76% of all cases stained for at least one of the antibodies. Fifty-eight percent (n = 14/24) and 33% (8/24) of all cases of papillary endothelial hyperplasia expressed FOS and FOSB, respectively. Thirty-two per cent of lobular capillary hemangiomas (n = 8/25) were positive for either FOS or FOSB. Conclusion: In summary, we present the largest cohort of epithelioid hemangiomas assessed with both FOS and FOSB and demonstrated that the use of both antibodies increases the detection rate of these proliferations by 10%. Nonetheless, the use of thresholds may not be appropriate, as only a subset of lesional endothelial cells label with FOS/FOSB. Over half of all cases of papillary endothelial hyperplasia and a third of lobular capillary hemangiomas also displayed immunoreactivity with FOS and/or FOSB.
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Affiliation(s)
- Kwan Yee Tsui
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
| | - Fiona Maclean
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Australia
- Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| | - Denis Moir
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
| | - Alison Cheah
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
| | - Fiona Bonar
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
| | - Joel Tabot
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
| | - Anthony J. Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Australia
- University of Sydney, Sydney, Australia
- NSW Health Pathology, Department of Anatomical Patohlogy, Royal North Shore Hospital, St Leonards, Australia
| | - A. Cristina Vargas
- Douglass Hanly Moir Pathology, Sonic Healthcare, Macquarie Park, Australia
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, Australia
- University of Sydney, Sydney, Australia
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18
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Primary Benign Tumors of the Spinal Canal. World Neurosurg 2022; 164:178-198. [PMID: 35552036 DOI: 10.1016/j.wneu.2022.04.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 11/23/2022]
Abstract
Benign tumors that grow in the spinal canal are heterogeneous neoplasms with low incidence; from these, meningiomas and nerve sheath tumors (neurofibromas and schwannomas) account for 60%-70% of all primary spinal tumors. Benign spinal canal tumors provoke nonspecific clinical manifestations, mostly related to the affected level of the spinal cord. These tumors present a challenge for the patient and healthcare professionals, for they are often difficult to diagnose and the high frequency of posttreatment complications. In this review, we describe the epidemiology, risk factors, clinical features, diagnosis, histopathology, molecular biology, and treatment of extramedullary benign meningiomas, osteoid osteomas, osteoblastomas, aneurysmal bone cysts, osteochondromas, neurofibromas, giant cell tumors of the bone, eosinophilic granulomas, hemangiomas, lipomas, and schwannomas located in the spine, as well as possible future targets that could lead to an improvement in their management.
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19
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Heitkötter B, Hartmann W. [Giant cell-containing tumors of bone and differential diagnoses]. DER PATHOLOGE 2022; 43:174-182. [PMID: 35467097 DOI: 10.1007/s00292-022-01069-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/08/2022] [Indexed: 06/14/2023]
Abstract
Osteoclastic giant cells represent a common cellular component of lesions arising in bone. Highlighting this morphological finding, the current WHO classification of bone tumors defines a diagnostic group comprising aneurysmal bone cyst, giant cell tumor of bone and non-ossifying fibroma, which may display morphologic similarities while being distinct with regard to molecular and biological features. Starting with these tumors - putting a focus on lesions arising in bone - this article gives a survey of other (chondrogenic and osteogenic) tumors that frequently contain osteoclastic giant cells, which may, particularly in small biopsies, enter differential diagnosis. Overlapping features with selected giant cell-containing soft tissue tumors, which may be of differential diagnostic relevance in daily routine, are discussed.
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Affiliation(s)
- Birthe Heitkötter
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland
| | - Wolfgang Hartmann
- Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
- Sektion für Translationale Pathologie, Gerhard-Domagk-Institut für Pathologie, Universitätsklinikum Münster, Albert-Schweitzer-Campus 1, 48149, Münster, Deutschland.
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20
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Hung YP, Bredella MA, Lobmaier IVK, Lozano-Calderón SA, Rosenberg AE, Nielsen GP. Aneurysmal bone cyst and osteoblastoma after neoadjuvant denosumab: histologic spectrum and potential diagnostic pitfalls. APMIS 2022; 130:206-214. [PMID: 35114728 DOI: 10.1111/apm.13211] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/27/2022] [Indexed: 01/28/2023]
Abstract
The use of denosumab to treat giant cell tumors of bone (GCT) and other giant cell-containing bone tumors has become more common. While the clinicopathologic features of denosumab-treated giant cell tumors of bone have been well-illustrated, descriptions of other denosumab-treated bone tumors are very limited. Surgical pathology files of two institutions and consultation files from two authors were searched for denosumab-treated aneurysmal bone cysts and denosumab-treated osteoblastomas. Clinicopathologic features were reviewed and analyzed. We identified four patients with denosumab-treated bone tumors other than GCT from our surgical pathology and consultation files, including two aneurysmal bone cysts and two osteoblastomas. All were treated with denosumab for 0.5-7.0 (median 4.5) months. Radiologically, denosumab-treated tumors showed decreased size with increased ossification and mineralization on CT and heterogeneous intermediate to hypointense signal on MRI. Histologically, denosumab-treated aneurysmal bone cyst contained thin, elongated, curvilinear, and anastomosing strands of bone with empty lacunae, while denosumab-treated osteoblastoma showed circumscribed nodules of woven bone lined by small osteoblasts. Denosumab-treated aneurysmal bone cyst and osteoblastoma showed treatment-related morphologic changes that can mimic other bone neoplasms. Their recognition requires correlation with the clinical history of denosumab use and radiologic findings.
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Affiliation(s)
- Yin P Hung
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Ingvild V K Lobmaier
- Department of Pathology, Oslo University Hospital, The Norwegian Radium Hospital, Oslo, Norway
| | | | - Andrew E Rosenberg
- Department of Pathology and Laboratory Medicine, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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21
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Suster D, Mackinnon AC, Jarzembowski JA, Carrera G, Suster S, Klein MJ. Epithelioid osteoblastoma. Clinicopathologic and immunohistochemical study of 17 cases. Hum Pathol 2022; 125:68-78. [PMID: 35337839 DOI: 10.1016/j.humpath.2022.03.006] [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: 01/25/2022] [Revised: 03/10/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
Seventeen cases of epithelioid osteoblastoma were reviewed. The tumors most commonly arose from the vertebrae (7 cases), followed by the mandible (3), sacrum (2), bones of the foot (2), and femur, rib, and scapula (1 each). Patients' ages ranged from 5 to 33 years. The tumors measured from 2.0 to 6.5 cm in the greatest diameter (mean = 4.1 cm) and most patients presented with low-grade pain at the affected site. Imaging studies showed expansile lytic lesions with cortical thickening and a mild rim of sclerosis. Histologically all tumors were characterized by active production of bone with a fibrovascular stroma containing microtrabecular aggregates of bone matrix. The osteoblastic proliferation was atypical and showed enlarged cells with prominent nucleoli and abundant cytoplasm imparting them with a striking epithelioid appearance. Immunohistochemical studies showed variable results that caused difficulties for interpretation; 4 of 12 cases showed strong nuclear positivity for FOS, 2 of 12 cases showed strong diffuse nuclear positivity for FOSB; the remaining cases showed variable, sometimes overlapping patterns, considered to be indeterminate. Ki-67 proliferation marker showed low nuclear positivity (∼2%) in 10 cases and a slight increase (<10%) in two cases. Clinical follow-up was available in 14 patients; one patient experienced a recurrence at six months that was treated with additional curetting; the remainder of the patients were all alive and well without evidence of recurrence from 1 to 22 years (median follow up = 3 years). Epithelioid osteoblastoma is an unusual variant of osteoblastoma that has the potential for simulating a malignancy and does not appear to be associated with a more aggressive behavior.
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Affiliation(s)
- David Suster
- From the Department of Pathology, Rutgers University School of Medicine, Newark, NJ, 07103, USA.
| | - A Craig Mackinnon
- Department of Pathology, University of Alabama at Birmingham, AL, 35249, USA
| | | | - Guillermo Carrera
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Saul Suster
- Department of Pathology, The Medical College of Wisconsin, Milwaukee, WI, 53226, USA
| | - Michael J Klein
- Department of Pathology, Hospital for Special Surgery, New York, NY, 10021, USA
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22
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Epithelioid osteoblastoma with secondary aneurysmal bone cyst and FOS gene rearrangement. Skeletal Radiol 2022; 51:673-679. [PMID: 34448010 DOI: 10.1007/s00256-021-03895-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/16/2021] [Accepted: 08/19/2021] [Indexed: 02/02/2023]
Abstract
Epithelioid osteoblastoma, sometimes equated with aggressive osteoblastoma, is a variant of osteoblastoma that typically demonstrates more worrisome imaging and pathological features compared to conventional osteoblastoma. These more aggressive features can overlap with those seen in osteosarcoma, creating a diagnostic challenge for radiologists and pathologists. Recent identification of FOS and FOSB gene rearrangements in osteoid osteoma and osteoblastoma has allowed for greater diagnostic confidence following biopsy, but careful radiological-pathological correlation remains a key component for guiding appropriate management. Although the imaging features of conventional osteoblastoma have been previously described, there are limited examples in the literature of the imaging appearance of epithelioid osteoblastoma, and none with secondary aneurysmal bone cyst. In this case report, we detail the clinical, imaging, and histological characteristics of a proximal femoral epithelioid osteoblastoma which was pathologically confirmed by FOS and FOSB genetic testing. The initial imaging impression favored a malignancy, but when the biopsy results were correlated in a multidisciplinary fashion with the imaging, epithelioid osteoblastoma became the leading diagnosis which was subsequently genetically confirmed. This case emphasizes the value of multidisciplinary radiology-pathology correlation in routine practice.
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23
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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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24
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Wang XQ, Goytain A, Dickson BC, Nielsen TO. Advances in Sarcoma Molecular Diagnostics. Genes Chromosomes Cancer 2022; 61:332-345. [DOI: 10.1002/gcc.23025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Xue Qi Wang
- Faculty of Medicine University of British Columbia Vancouver Canada
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine University of British Columbia Vancouver Canada
| | - Angela Goytain
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine University of British Columbia Vancouver Canada
| | - Brendan C. Dickson
- Department of Pathology & Laboratory Medicine, Mount Sinai Hospital; Department of Laboratory Medicine and Pathobiology University of Toronto Toronto ON Canada
| | - Torsten Owen Nielsen
- Genetic Pathology Evaluation Centre, Department of Pathology and Laboratory Medicine University of British Columbia Vancouver Canada
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25
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Ameline B, Nathrath M, Nord KH, de Flon FH, Bovée JVMG, Krieg AH, Höller S, Hench J, Baumhoer D. Methylation and copy number profiling: emerging tools to differentiate osteoblastoma from malignant mimics? Mod Pathol 2022; 35:1204-1211. [PMID: 35347251 PMCID: PMC9424109 DOI: 10.1038/s41379-022-01071-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/21/2022] [Accepted: 02/21/2022] [Indexed: 11/09/2022]
Abstract
Rearrangements of the transcription factors FOS and FOSB have recently been identified as the genetic driver event underlying osteoid osteoma and osteoblastoma. Nuclear overexpression of FOS and FOSB have since then emerged as a reliable surrogate marker despite limitations in specificity and sensitivity. Indeed, osteosarcoma can infrequently show nuclear FOS expression and a small fraction of osteoblastomas seem to arise independent of FOS/FOSB rearrangements. Acid decalcification and tissue preservation are additional factors that can negatively influence immunohistochemical testing and make diagnostic decision-making challenging in individual cases. Particularly aggressive appearing osteoblastomas, also referred to as epithelioid osteoblastomas, and osteoblastoma-like osteosarcoma can be difficult to distinguish, underlining the need for additional markers to support the diagnosis. Methylation and copy number profiling, a technique well established for the classification of brain tumors, might fill this gap. Here, we set out to comprehensively characterize a series of 77 osteoblastomas by immunohistochemistry, fluorescence in-situ hybridization as well as copy number and methylation profiling and compared our findings to histologic mimics. Our results show that osteoblastomas are uniformly characterized by flat copy number profiles that can add certainty in reaching the correct diagnosis. The methylation cluster formed by osteoblastomas, however, so far lacks specificity and can be misleading in individual cases.
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Affiliation(s)
- Baptiste Ameline
- grid.6612.30000 0004 1937 0642Bone Tumor Reference Center at the Institute for Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michaela Nathrath
- grid.6936.a0000000123222966Department of Pediatrics and Children’s Cancer Research Center, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany ,grid.419824.20000 0004 0625 3279Pediatric Hematology and Oncology, Klinikum Kassel, Kassel, Germany
| | - Karolin H. Nord
- grid.4514.40000 0001 0930 2361Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Felix Haglund de Flon
- grid.4714.60000 0004 1937 0626Department of Oncology-Pathology, Karolinska Institutet, Solna, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Clinical Pathology and Cancer Diagnostics, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Judith V. M. G. Bovée
- grid.10419.3d0000000089452978Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andreas H. Krieg
- grid.6612.30000 0004 1937 0642Bone and Soft tissue Sarcoma Center, University of Basel, University Children’s Hospital Basel (UKBB), Basel, Switzerland
| | - Sylvia Höller
- grid.6612.30000 0004 1937 0642Bone Tumor Reference Center at the Institute for Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland ,grid.7400.30000 0004 1937 0650Stadtspital Zürich, Institute of Clinical Pathology, University of Zürich, Zürich, Switzerland
| | - Jürgen Hench
- grid.410567.1Institute for Medical Genetics and Pathology, Division of Neuropathology, University Hospital Basel, Basel, Switzerland
| | - Daniel Baumhoer
- Bone Tumor Reference Center at the Institute for Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland.
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26
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Abstract
Diagnosis of osteosarcoma can be challenging because of its diverse histological patterns and the lack of diagnostic biomarkers for most examples. This review summarizes the key pathologic findings of osteosarcoma subtypes (high-grade central, parosteal, low-grade central, periosteal, high-grade surface, and secondary) with an emphasis on describing and illustrating histological heterogeneity to help general pathologists. Differential diagnoses are listed for each entity, and histological subtype and distinguishing features, including molecular genetic findings (eg, MDM2, IDH, H3F3A, FOS, and USP6), are discussed. The review also covers recently established and emerging concepts and controversies regarding osteosarcoma.
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Affiliation(s)
- Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan.
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27
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Abstract
Benign bone-forming tumors comprise osteomas, osteoid osteomas, and osteoblastomas. Osteomas affect a wide age range and are usually discovered incidentally. They occur predominantly in the craniofacial skeleton and are classically composed of compact bone. Osteoid osteomas and osteoblastomas are painful lesions occurring in young patients. They are morphologically similar and characterized by FOS gene rearrangement and c-FOS expression at a protein level. Osteoid osteomas are usually smaller than 2 cm in maximum dimension with limited growth potential; osteoblastomas are larger than 2 cm and may be locally aggressive. Histologically both are composed of anastomosing trabeculae of woven bone.
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Affiliation(s)
- Fernanda Amary
- Histopathology Department, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Greater London HA7 4LP, UK; Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK.
| | - Adrienne M Flanagan
- Histopathology Department, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Greater London HA7 4LP, UK; Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK
| | - Paul O'Donnell
- Cancer Institute, University College London, 72 Huntley Street, London WC1E 6DD, UK; Radiology Department, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Greater London HA7 4LP, UK
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28
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Abstract
Cementoblastomas are rare odontogenic tumors developing in close proximity to the roots of teeth. Due to their striking morphologic resemblance to osteoblastomas of the peripheral skeleton, we set out to determine whether cementoblastomas harbor the same FOS rearrangements with overexpression of c-FOS as has recently been described for osteoblastomas. In total, 16 cementoblastomas were analyzed for FOS expression by immunohistochemistry and for FOS rearrangements by fluorescence in situ hybridization (FISH). We observed strong and diffuse staining of c-FOS in 71% of cementoblastomas and identified a FOS rearrangement in all cases (n=3) applicable for FISH. In the remaining cases, FISH failed due to decalcification. Cementoblastomas harbor similar FOS rearrangements and show overexpression of c-FOS like osteoblastomas, suggesting that both entities might represent parts of the spectrum of the same disease.
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29
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Danzinger S, Kager L, Bernathova M, Lang S, Haslik W, Singer CF. Extraosseous osteoblastoma: A rare cause of breast mass in a prepubertal girl. Clin Case Rep 2021; 9:e04094. [PMID: 34084506 PMCID: PMC8142408 DOI: 10.1002/ccr3.4094] [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: 11/06/2020] [Revised: 03/05/2021] [Accepted: 03/14/2021] [Indexed: 11/09/2022] Open
Abstract
Extraosseous osteoblastoma of the breast, a rare disease, was diagnosed in a prepubertal girl. After tumor excision, the patient recovered well and an optimal cosmetic result was achieved. Interdisciplinary discussions about the case are essential.
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Affiliation(s)
- Sabine Danzinger
- Department of Obstetrics and GynecologyMedical University of ViennaViennaAustria
| | - Leo Kager
- St. Anna Children's HospitalDepartment of PediatricsMedical University of ViennaViennaAustria
| | - Maria Bernathova
- Department of Biomedical Imaging and Image‐Guided TherapyMedical University of ViennaViennaAustria
| | - Susanna Lang
- Department of PathologyMedical University of ViennaViennaAustria
| | - Werner Haslik
- Clinical Division of Plastic and Reconstructive SurgeryDepartment of SurgeryMedical University of ViennaViennaAustria
| | - Christian F. Singer
- Department of Obstetrics and GynecologyMedical University of ViennaViennaAustria
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30
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Novel GATA6-FOXO1 fusions in a subset of epithelioid hemangioma. Mod Pathol 2021; 34:934-941. [PMID: 33318580 PMCID: PMC8076054 DOI: 10.1038/s41379-020-00723-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
The genetic hallmark of epithelioid hemangioma (EH) is the presence of recurrent gene fusions involving FOS and FOSB transcription factors, which occur in one-third of the cases. Certain clinical, pathologic, and genotypic correlations have been described, with FOS-related fusions being more often detected in skeletal and cellular variants of EH, while FOSB gene rearrangements are more commonly associated with atypical histologic features and penile location. These fusions are infrequently detected in the cutaneous or head and neck EH. Overall, two-thirds of EH lack these canonical fusions and remain difficult to classify, especially when associated with atypical features and/or clinical presentations. Triggered by an index case of an intravascular soft tissue EH with a novel GATA6-FOXO1 gene fusion by targeted RNA sequencing (Archer® FusionPlex® Sarcoma Panel), we have investigated 27 additional EH cases negative for FOS and FOSB gene rearrangements for this novel abnormality to determine its recurrent potential, and its association with clinical and pathologic features. Four additional EH cases were found to display GATA6-FOXO1 fusions (18%). There were three females and two males, with a mean age of 32 years old. Three lesions occurred in the head and neck (dura, nasopharyngeal, and cheek), one in the back and one in the leg. Two of these lesions were cutaneous and one was intravascular in the subcutis of the leg. Microscopically, the tumors showed a variegated morphology, with alternating vasoformative and solid components, extravasated red blood cells and mild to moderate cytologic atypia. None showed brisk mitotic activity or necrosis. Tumors were negative for FOS and FOSB by immunohistochemistry. In conclusion, we report a new GATA6-FOXO1 fusion in a subset of EH, with a predilection for skin, and head and neck location. The relationship of this novel molecular subset with the more common FOS/FOSB fusion-positive EH remains to be determined.
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31
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Makise N, Mori T, Motoi T, Shibahara J, Ushiku T, Yoshida A. Recurrent FOS rearrangement in proliferative fasciitis/proliferative myositis. Mod Pathol 2021; 34:942-950. [PMID: 33318581 DOI: 10.1038/s41379-020-00725-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/09/2020] [Accepted: 11/05/2020] [Indexed: 11/09/2022]
Abstract
Proliferative fasciitis (PF) and proliferative myositis (PM) are rare benign soft tissue lesions, usually affecting the extremities of middle-aged or older adults. Presenting as poorly circumscribed masses, they histologically show bland spindle cell proliferation in a myxoid to fibrous background and a hallmark component of large epithelioid "ganglion-like" cells in various numbers, which may lead to their misdiagnosis as sarcoma. PF/PM has been long considered as reactive, akin to nodular fasciitis; however, its pathogenesis has remained unknown. In this study, we analyzed the FOS status in 6 PF/PMs (5 PFs and 1 PM). Five PF/PMs occurred in adults, all showing diffuse strong expression of c-FOS primarily in the epithelioid cells, whereas spindle cell components were largely negative. Using fluorescence in situ hybridization (FISH), all 5 c-FOS-immunopositive tumors showed evidence of FOS gene rearrangement in the epithelioid cells. RNA sequencing in 1 case detected a FOS-VIM fusion transcript, which was subsequently validated by reverse transcriptase-polymerase chain reaction, Sanger sequencing, and VIM FISH. The one pediatric PF case lacked c-FOS expression and FOS rearrangement. c-FOS immunohistochemistry was negative in 45 cases of selected mesenchymal tumor types with epithelioid components that may histologically mimic PF/PM, including pleomorphic sarcoma with epithelioid features and epithelioid sarcoma. Recurrent FOS rearrangement and c-FOS overexpression in PF/PM suggested these lesions to be neoplastic. FOS abnormality was largely restricted to the epithelioid cell population, clarifying the histological composition of at least 2 different cell types. c-FOS immunohistochemistry may serve as a useful adjunct to accurately distinguish PF/PM from mimics.
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Affiliation(s)
- Naohiro Makise
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taisuke Mori
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.,Division of Molecular Pathology, National Cancer Center Research Institute, Tokyo, Japan
| | - Toru Motoi
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Junji Shibahara
- Department of Pathology, Kyorin University School of Medicine, Tokyo, Japan
| | - Tetsuo Ushiku
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan. .,Rare Cancer Center, National Cancer Center Hospital, Tokyo, Japan.
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Abstract
Bone tumors are a rare and heterogeneous group of neoplasms that occur in the bone. The diversity and considerable morphologic overlap of bone tumors with other mesenchymal and nonmesenchymal bone lesions can complicate diagnosis. Accurate histologic diagnosis is crucial for appropriate management and prognostication. Since the publication of the fourth edition of the World Health Organization (WHO) classification of tumors of soft tissue and bone in 2013, significant advances have been made in our understanding of bone tumor molecular biology, classification, prognostication, and treatment. Detection of tumor-specific molecular alterations can facilitate the accurate diagnosis of histologically challenging cases. The fifth edition of the 2020 WHO classification of tumors of soft tissue and bone tumors provides an updated classification scheme and essential diagnostic criteria for bone tumors. Herein, we summarize these updates, focusing on major changes in each category of bone tumor, the newly described tumor entities and subtypes of existing tumor types, and newly described molecular and genetic data.
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Affiliation(s)
- Joon Hyuk Choi
- Department of Pathology, Yeungnam University College of Medicine, Daegu, South Korea
| | - Jae Y Ro
- Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX
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33
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Diagnostic Immunohistochemistry of Soft Tissue and Bone Tumors: An Update on Biomarkers That Correlate with Molecular Alterations. Diagnostics (Basel) 2021; 11:diagnostics11040690. [PMID: 33921435 PMCID: PMC8069362 DOI: 10.3390/diagnostics11040690] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023] Open
Abstract
The diagnosis of benign and malignant soft tissue and bone neoplasms is a challenging area of surgical pathology, due to the large number, rarity, and histologic diversity of tumor types. In recent years, diagnosis and classification has been aided substantially by our growing understanding of recurrent molecular alterations in these neoplasms. Concurrently, the role of diagnostic immunohistochemistry has also expanded, with the development of numerous biomarkers based on underlying molecular events. Such biomarkers allow us to infer the presence of these events and can therefore substitute for other ancillary molecular genetic techniques (e.g., fluorescence in situ hybridization, polymerase chain reaction, and next-generation sequencing). In this review, we discuss a range of biomarkers currently available for these neoplasms, highlighting the accuracy, staining characteristics, and interpretation pitfalls of each antibody. These include immunohistochemical antibodies that represent reliable surrogates for the detection of gene fusions (e.g., STAT6, CAMTA1, FOSB, DDIT3) and more recently described breakpoint-specific antibodies (e.g., SS18-SSX, PAX3/7-FOXO1). Additionally, discussed are markers that correlate with the presence of gene amplifications (e.g., MDM2, CDK4), deletions (e.g., SMARCB1, SMARCA4), single nucleotide variants (e.g., G34W, K36M), aberrant methylation (H3K27me3), and increased expression as discovered through gene expression profiling (e.g., MUC4, DOG1, ETV4, NKX2.2, NKX3.1).
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Abstract
We present a review of several bone (osteoid)-forming tumors including enostosis, osteoid osteoma, osteoblastoma, and osteosarcoma. These entities were chosen because they are reasonably common-neither seen every day nor rare. When applicable, recent information about the lesions is included.
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Affiliation(s)
- Behrang Amini
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX.
| | - Raul Fernando Valenzuela
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Justin E Bird
- Department of Orthopaedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Tamara Miner Haygood
- Department of Musculoskeletal Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX
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35
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Muhammed A, Meshneb M, Saro H, Elnakib N, Elnakib E. Management of cranial chondroblastoma in adults; a pooled analysis. Am J Otolaryngol 2020; 41:102486. [PMID: 32305254 DOI: 10.1016/j.amjoto.2020.102486] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 04/04/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Chondroblastoma is a rare bone tumour that often affects children more than adults. The adult cranial affection is a unique presentation of the disease (less than 2%) that mandates specific management. Through this pooled-analysis, we aimed to examine this disease group and obtain reliable scientific conclusions. METHODS The literature was searched for case-reports of cranial chondroblastoma. Afterwards, a pooled analysis was done for the selected articles. The data in question were the patient's age, gender, disease site, modalities of treatment, disease control, salvage treatment, and disease-specific survival. RESULTS 122 case reports were retrieved from the literature. The median age at diagnosis was 38.5 years. Up to the moment, the standard of care remains complete resection. The relapse-free survival was 29.5 months, with a three-year relapse rate of 9% and disease-specific mortality of 0%. Most of the relapses were salvaged excellently with excision. The strongest predictor for relapse was the post-resection residual disease, with three-years relapse rates of 23.8% and 2.4% for positive and negative residuals, respectively. Adjuvant Radiotherapy failed to improve the relapse rates. CONCLUSION Complete surgical excision is the standard of care. Post-surgical residual is the only adverse prognostic factor that predicts poor disease control.
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Affiliation(s)
- Amr Muhammed
- Clinical Oncology Department, Sohag University Hospital, Egypt.
| | | | - Hossam Saro
- Clinical Radiology department, Sohag University Hospital, Egypt
| | | | - Esraa Elnakib
- Clinical Oncology Department, Sohag University Hospital, Egypt
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36
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Saba KH, Cornmark L, Hofvander J, Magnusson L, Nilsson J, van den Bos H, Spierings DC, Foijer F, Staaf J, Brosjö O, Sumathi VP, Lam SW, Szuhai K, Bovée JV, Kovac M, Baumhoer D, Styring E, Nord KH. Loss of NF2 defines a genetic subgroup of non-FOS-rearranged osteoblastoma. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2020; 6:231-237. [PMID: 32542935 PMCID: PMC7578308 DOI: 10.1002/cjp2.172] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022]
Abstract
Osteoblastoma is a locally aggressive tumour of bone. Until recently, its underlying genetic features were largely unknown. During the past two years, reports have demonstrated that acquired structural variations affect the transcription factor FOS in a high proportion of cases. These rearrangements modify the terminal exon of the gene and are believed to stabilise both the FOS transcript and the encoded protein, resulting in high expression levels. Here, we applied in‐depth genetic analyses to a series of 29 osteoblastomas, including five classified as epithelioid osteoblastoma. We found recurrent homozygous deletions of the NF2 gene in three of the five epithelioid cases and in one conventional osteoblastoma. These events were mutually exclusive from FOS mutations. Structural variations were determined by deep whole genome sequencing and the number of FOS‐rearranged cases was less than previously reported (10/23, 43%). One conventional osteoblastoma displayed a novel mechanism of FOS upregulation; bringing the entire FOS gene under the control of the WNT5A enhancer that is itself activated by FOS. Taken together, we show that NF2 loss characterises a subgroup of osteoblastomas, distinct from FOS‐rearranged cases. Both NF2 and FOS are involved in regulating bone homeostasis, thereby providing a mechanistic link to the excessive bone growth of osteoblastoma.
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Affiliation(s)
- Karim H Saba
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Louise Cornmark
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Jakob Hofvander
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Linda Magnusson
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Jenny Nilsson
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
| | - Hilda van den Bos
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Diana Cj Spierings
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Floris Foijer
- European Research Institute for the Biology of Ageing, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johan Staaf
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Lund, Sweden
| | - Otte Brosjö
- Department of Orthopedics, Karolinska University Hospital, Stockholm, Sweden
| | - Vaiyapuri P Sumathi
- Department of Musculoskeletal Pathology, Royal Orthopaedic Hospital, Birmingham, UK
| | - Suk Wai Lam
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Karoly Szuhai
- Department of Cell and Chemical Biology, Leiden University Medical Center, Leiden, The Netherlands
| | - Judith Vmg Bovée
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Michal Kovac
- Bone Tumour Reference Centre at the Institute of Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - Daniel Baumhoer
- Bone Tumour Reference Centre at the Institute of Pathology, University Hospital and University of Basel, Basel, Switzerland
| | - Emelie Styring
- Department of Orthopedics, Lund University, Skåne University Hospital, Lund, Sweden
| | - Karolin H Nord
- Department of Laboratory Medicine, Division of Clinical Genetics, Lund University, Lund, Sweden
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37
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Sun Y, Zhao M, Lao IW, Yu L, Wang J. The clinicopathological spectrum of pseudomyogenic hemangioendothelioma: report of an additional series with review of the literature. Virchows Arch 2020; 477:231-240. [PMID: 31980959 DOI: 10.1007/s00428-020-02753-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 01/02/2020] [Accepted: 01/10/2020] [Indexed: 12/22/2022]
Abstract
We present here our experience with 24 cases of pseudomyogenic hemangioendothelioma (PMHE) to further delineate its clinicopathological spectrum. There were 18 males and 6 females with a median age of 28 years (range 10~64 years). Most patients presented with erythematous nodules or papules, with or without pain. The majority (63%) occurred in the lower extremities, whereas a minority involved the trunk (25%), upper extremities (8%), and head and neck (4%). Six cases (25%) had a primary bone origin. With physical and radiological examinations, 16 cases (67%) manifested as multifocal disease, involving multiple tissue planes or different bones within the anatomic region. Six cases (25%) involved skin, soft tissue, and bone simultaneously. Histologically, all cases showed features consistent with a PMHE characterized by loose fascicles or sheets of plump spindled to epithelioid cells harboring brightly eosinophilic cytoplasm and vesicular nuclei. In addition, five cases (21%) contained a prominent myxoid matrix, and one case displayed perineural and intravascular invasion. The follow-up information available in 18 patients revealed local recurrence in 4 patients (22%) and persistent disease in 8 patients (44%), respectively. One patient developed bilateral pulmonary metastases which showed significant remission after systemic chemotherapy. None of the patients died of the disease. As the clinical appearance of PMHE can be deceptive, a radiological examination is essential in identifying an insidious multifocal disease. Although PMHE has a predilection for the distal extremities of young males, this rare tumor type could also occur in unusual sites and affect middle-aged adults of both genders. The striking myoid appearance in association with myxoid stromal change may represent a potential diagnostic pitfall. Biologically, PMHE has an indolent clinical behavior, albeit metastatic disease may occur in rare instance.
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Affiliation(s)
- Yuefang Sun
- Department of Pathology, Shanghai Tenth People's Hospital, Tenth People's Hospital of Tongji University, 301 Yanchang Middle Road, Shanghai, 200072, China
| | - Ming Zhao
- Department of Pathology, Zhejiang Provincial People's Hospital, Hangzhou, 310014, China
| | - I Weng Lao
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology Shanghai Medical College, Fudan University, 270 Dong An St, Shanghai, 200032, China
| | - Lin Yu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China
- Department of Oncology Shanghai Medical College, Fudan University, 270 Dong An St, Shanghai, 200032, China
| | - Jian Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
- Department of Oncology Shanghai Medical College, Fudan University, 270 Dong An St, Shanghai, 200032, China.
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38
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Cleven AHG, Schreuder WH, Groen E, Kroon HM, Baumhoer D. Molecular findings in maxillofacial bone tumours and its diagnostic value. Virchows Arch 2019; 476:159-174. [PMID: 31838586 PMCID: PMC6968989 DOI: 10.1007/s00428-019-02726-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/04/2019] [Accepted: 11/25/2019] [Indexed: 02/08/2023]
Abstract
According to the WHO, mesenchymal tumours of the maxillofacial bones are subdivided in benign and malignant maxillofacial bone and cartilage tumours, fibro-osseous and osteochondromatous lesions as well as giant cell lesions and bone cysts. The histology always needs to be evaluated considering also the clinical and radiological context which remains an important cornerstone in the classification of these lesions. Nevertheless, the diagnosis of maxillofacial bone tumours is often challenging for radiologists as well as pathologists, while an accurate diagnosis is essential for adequate clinical decision-making. The integration of new molecular markers in a multidisciplinary diagnostic approach may not only increase the diagnostic accuracy but potentially also identify new druggable targets for precision medicine. The current review provides an overview of the clinicopathological and molecular findings in maxillofacial bone tumours and discusses the diagnostic value of these genetic aberrations.
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Affiliation(s)
- Arjen H G Cleven
- Department of Pathology, Leiden University Medical Center, PO, Box 9600, L1-Q, 2300 RC, Leiden, the Netherlands.
| | - Willem H Schreuder
- Department of Oral and Maxillofacial Surgery/Head and Neck Surgery, Amsterdam University Medical Center/Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands
| | - Eline Groen
- Department of Pathology, Leiden University Medical Center, PO, Box 9600, L1-Q, 2300 RC, Leiden, the Netherlands
| | - Herman M Kroon
- Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Daniel Baumhoer
- Bone Tumour Reference Centre, Institute of Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
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