1
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Yoshida A. NUT carcinoma and thoracic SMARCA4-deficient undifferentiated tumour: facts and controversies. Histopathology 2024; 84:86-101. [PMID: 37873676 DOI: 10.1111/his.15063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/09/2023] [Accepted: 09/24/2023] [Indexed: 10/25/2023]
Abstract
NUT carcinoma and thoracic SMARCA4-deficient undifferentiated tumour are unique entities in the 5th edition of the World Health Organisation (WHO) Classification of Thoracic Tumours, whose definitions include molecular genetic abnormalities. These aggressive tumours require rapid work-ups on biopsies, but a broad list of differential diagnoses poses challenges for practising pathologists. This review provides an update on their key clinicopathological and molecular characteristics, as well as controversies regarding tumour classification and diagnostic strategy. Phenotypical assessment plays a substantial role in diagnosis because recurrent and predictable clinicopathological findings exist, including robust immunohistochemical phenotypes. Accurate diagnosis is crucial for appropriate management and a clearer understanding of the disease.
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Affiliation(s)
- Akihiko Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan
- Rare Cancer Center, National Cancer Center, Tokyo, Japan
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2
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SMARCB1-deficient and SMARCA4-deficient Malignant Brain Tumors With Complex Copy Number Alterations andTP53Mutations May Represent the First Clinical Manifestation of Li-Fraumeni Syndrome. Am J Surg Pathol 2022; 46:1277-1283. [PMID: 35446794 DOI: 10.1097/pas.0000000000001905] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Atypical teratoid/rhabdoid tumor (AT/RT) is a malignant central nervous system tumor predominantly affecting infants. Mutations ofSMARCB1or (rarely)SMARCA4causing loss of nuclear SMARCB1 or SMARCA4 protein expression are characteristic features, but further recurrent genetic alterations are lacking. Most AT/RTs occur de novo, but secondary AT/RTs arising from other central nervous system tumors have been reported. Malignant gliomas, IDH wild-type, arising in patients with Li-Fraumeni syndrome typically show somatic mutations ofTP53as well as complex copy number alterations, but little is known about the loss of SMARCB1 or SMARCA4 protein expression in this context. Here, we report 2 children in whom malignant supratentorial brain tumors with SMARCB1 deficiency, complex copy number alterations, and somaticTP53mutations lead to the discovery of pathogenic/likely pathogenicTP53variants in the germline. Screening of the molecularneuropathology.org dataset for cases with similar genetic and epigenetic alterations yielded another case with SMARCA4 deficiency in a young adult with Li-Fraumeni syndrome. In conclusion, SMARCB1-deficient or SMARCA4-deficient malignant brain tumors with complex copy number alterations and somaticTP53mutations in children and young adults may represent the first clinical manifestation of Li-Fraumeni syndrome and should prompt genetic counseling and investigation forTP53germline status.
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3
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Hasselblatt M, Thomas C, Federico A, Bens S, Hellström M, Casar‐Borota O, Kordes U, Neumann JE, Dottermusch M, Rodriguez FJ, Lo AC, Cheng S, Hendson G, Hukin J, Hartmann C, Koch A, Capper D, Siebert R, Paulus W, Nemes K, Johann PD, Frühwald MC, Kool M. Low‐grade diffusely infiltrative tumour (LGDIT), SMARCB1‐mutant: a clinical and histopathological distinct entity showing epigenetic similarity with ATRT‐MYC. Neuropathol Appl Neurobiol 2022; 48:e12797. [DOI: 10.1111/nan.12797] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/03/2022] [Accepted: 02/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Christian Thomas
- Institute of Neuropathology University Hospital Münster Münster Germany
| | - Aniello Federico
- Hopp Children´s Cancer Center (KiTZ), Heidelberg Germany
- Division of Paediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg Germany
| | - Susanne Bens
- Institute of Human Genetics Ulm University & Ulm University Medical Center Ulm Germany
| | - Mats Hellström
- Dept. of Immunology, Genetics and Pathology, Rudbeck Laboratory Uppsala University Uppsala Sweden
| | - Olivera Casar‐Borota
- Dept. of Immunology, Genetics and Pathology, Rudbeck Laboratory Uppsala University Uppsala Sweden
- Dept. of Clinical Pathology Uppsala University Hospital Uppsala Sweden
| | - Uwe Kordes
- Dept. of Pediatric Hematology and Oncology University Medical Center, Hamburg‐Eppendorf Hamburg Germany
| | - Julia E. Neumann
- Institute of Neuropathology, University Medical Center, Hamburg‐Eppendorf Hamburg Germany
- Center for Molecular Neurobiology Hamburg (ZMNH) University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Matthias Dottermusch
- Institute of Neuropathology, University Medical Center, Hamburg‐Eppendorf Hamburg Germany
- Center for Molecular Neurobiology Hamburg (ZMNH) University Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Fausto J. Rodriguez
- Dept. of Pathology The Johns Hopkins University School of Medicine Baltimore MD USA
| | - Andrea C. Lo
- Radiation Oncology British Columbia Cancer and University of British Columbia Vancouver Canada
| | - Sylvia Cheng
- Division of Hematology, Oncology & BMT, Department of Pediatrics University of British Columbia Vancouver Canada
| | - Glenda Hendson
- Dept. of Pathology, BC Women and Children's Hospital Vancouver Canada
| | - Juliette Hukin
- Division of Hematology, Oncology & BMT, Department of Pediatrics University of British Columbia Vancouver Canada
| | - Christian Hartmann
- Dept. of Neuropathology Institute of Pathology, Hannover Medical School Hannover Germany
| | - Arend Koch
- Charité ‐ Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Dept. of Neuropathology Berlin Germany
| | - David Capper
- Charité ‐ Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt‐Universität zu Berlin, Dept. of Neuropathology Berlin Germany
- German Cancer Consortium (DKTK), Partner Site Berlin, German Cancer Research Center (DKFZ), Heidelberg Germany
| | - Reiner Siebert
- Institute of Human Genetics Ulm University & Ulm University Medical Center Ulm Germany
| | - Werner Paulus
- Institute of Neuropathology University Hospital Münster Münster Germany
| | - Karolina Nemes
- Pediatric and Adolescent Medicine, Swabian Childrens' Cancer Center University Childrens' Hospital Medical Center Augsburg and EU‐RHAB Registry Augsburg Germany
| | - Pascal D. Johann
- Hopp Children´s Cancer Center (KiTZ), Heidelberg Germany
- Division of Paediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg Germany
- Pediatric and Adolescent Medicine, Swabian Childrens' Cancer Center University Childrens' Hospital Medical Center Augsburg and EU‐RHAB Registry Augsburg Germany
| | - Michael C. Frühwald
- Pediatric and Adolescent Medicine, Swabian Childrens' Cancer Center University Childrens' Hospital Medical Center Augsburg and EU‐RHAB Registry Augsburg Germany
| | - Marcel Kool
- Hopp Children´s Cancer Center (KiTZ), Heidelberg Germany
- Division of Paediatric Neurooncology, German Cancer Research Center (DKFZ) and German Cancer Consortium (DKTK), Heidelberg Germany
- Princess Máxima Center for Pediatric Oncology Utrecht The Netherlands
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4
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Nizolin DV, Fedorov EV, Kim AV, Mitrofanova LB, Khachatryan VA. [Combination of tumors of different histogenesis in pediatric neurosurgery]. ZHURNAL VOPROSY NEĬROKHIRURGII IMENI N. N. BURDENKO 2021; 85:80-90. [PMID: 33864672 DOI: 10.17116/neiro20218502180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Multiple gliomas are determined by synchronous two or more tumors located in different brain regions. It is important to distinguish multiple primary tumors and metastatic brain lesion. In the first case, tumor spread can`t be explained by dissemination along the cerebrospinal fluid pathways, commissural fibers or local metastases. Multiple primary tumors with different histological structures are called bidermal neoplasms. Surgery is preferred in these patients with severe symptoms. The purpose of surgery is maximum resection of tumor. Follow-up may be advisable for small tumors without clinical manifestations. Treatment of multiple gliomas includes surgery, radiotherapy and chemotherapy. Multiple tumor process in children is much more severe compared to a single neoplasia that requires neurological and neuroimaging control and determines treatment strategy. The authors report 3 children with multicentric gliomas, discuss the various aspects of diagnosis and treatment of multiple gliomas and formulate the recommendations for the treatment based on own clinical experience and literature data.
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Affiliation(s)
- D V Nizolin
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - E V Fedorov
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - A V Kim
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - L B Mitrofanova
- Almazov National Medical Research Center, St. Petersburg, Russia
| | - V A Khachatryan
- Almazov National Medical Research Center, St. Petersburg, Russia
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5
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Atypical Teratoid/Rhabdoid Tumor (AT/RT) With Molecular Features of Pleomorphic Xanthoastrocytoma. Am J Surg Pathol 2021; 45:1228-1234. [PMID: 33739782 DOI: 10.1097/pas.0000000000001694] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Atypical teratoid/rhabdoid tumor (AT/RT) is a highly malignant central nervous system tumor predominantly occurring in infants that may also arise in older children and adults. Rare secondary AT/RT developing from other tumors such as pleomorphic xanthoastrocytoma (PXA) are on record, but AT/RT presenting with molecular features of PXA have not been described. Here, we report 3 malignant central nervous system tumors in children (10, 13, and 18 y old). All tumors were located in the temporal lobe. In 2 cases, there was no history of a low-grade precursor lesion; in 1 case anaplastic PXA had been diagnosed 3 months earlier. Histopathologically, all tumors were composed of RT cells and showed frank signs of malignancy as well as loss of nuclear SMARCB1/INI1 protein expression. Two cases displayed homozygous deletions of the SMARCB1 region while the third case showed an exon 7 mutation (c.849_850delGT; p.Met283Ilefs*77). Of note, DNA methylation profiles did not group with AT/RT or other tumor entities using the Heidelberg Brain Tumor Classifier (version v11b4). By unsupervised t-distributed stochastic neighbor embedding analysis and hierarchical clustering analysis, however, all tumors clearly grouped with PXA. Genome-wide copy number analysis revealed homozygous CDNK2A/B deletions and gains of whole chromosome 7. BRAF V600E mutations could be demonstrated in all cases. In conclusion, the possibility of AT/RT with molecular features of PXA needs to be taken into account and warrants molecular characterization of AT/RT especially in older children. Since treatments targeting mutated BRAF are available, identification of such cases may also have therapeutic consequences.
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6
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CNS Low-grade Diffusely Infiltrative Tumors With INI1 Deficiency, Possessing a High Propensity to Progress to Secondary INI1-deficient Rhabdoid Tumors. Am J Surg Pathol 2020; 44:1459-1468. [PMID: 33045149 DOI: 10.1097/pas.0000000000001520] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Atypical teratoid/rhabdoid tumors (AT/RTs) are highly malignant tumors of the central nervous system that predominantly occur in infants, and are characterized by the presence of rhabdoid cells and inactivation of INI1 or (rarely) BRG1. Most AT/RT are identified as primary tumors; however, rare AT/RT or INI1-deficient RTs arising from other primary tumors have been reported. Here, we report 3 cases of hitherto unclassifiable low-grade tumors with loss of INI1 nuclear expression, for which we propose the designation of central nervous system low-grade diffusely infiltrative tumors with INI1 deficiency (CNS LGDIT-INI1), 2 of which progressed to secondary RT. All 3 CNS LGDIT-INI1 exhibited a similar histology: diffusely distributed small tumor cells with round to oval or irregular nuclei and scant cytoplasm were admixed with degenerative neurons and large reactive astrocytes in an edematous, myxoid, or collagenous background. Mitotic figures were absent. Immunohistochemistry revealed that the tumor cells in all 3 CNS LGDIT-INI1 and 2 RT were negative for INI1. Genetically, total or partial homozygous deletions of the INI1 gene were detected in all CNS LGDIT-INI1 and RT excluding 1 CNS LGDIT-INI1 without sufficient DNA quality and quantity. Despite the loss of INI1 expression, these low-grade lesions were clearly distinguishable from AT/RT by their low proliferative activity, diffusely infiltrative growth pattern, and lack of rhabdoid cells and polyphenotypic immunoreactivity. In conclusion, CNS LGDIT-INI1 may represent a rare group of tumors that are clinically indolent but have a high propensity to progress to RT.
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7
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Paz-Archila JA, Serrato-Avila JL, Pérez-Zapeta JM, Gatica-Gálvez JR. Atypical teratoid/rhabdoid tumor with ganglioglioma-like differentiation: Case report. Neurocirugia (Astur) 2020; 32:S1130-1473(20)30109-3. [PMID: 33071203 DOI: 10.1016/j.neucir.2020.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/16/2020] [Accepted: 08/27/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Atypical teratoide/rhabdoid tumor is a very rare and aggressive disease that primarily presents in pediatric patients. To the best of our knowledge, the initial presentation of this type of tumor with ganglioglioma-like differentiation is rare in the literature. CASE REPORT We present the case of a 9-month-old patient with left facial paralysis. An MRI revealed a lesion at the left cerebellopontine angle. Complete macroscopic surgical resection was performed. Histopathology and immunohistochemistry testing revealed an atypical teratoid/rhabdoid tumor with ganglioglioma-like differentiation. CONCLUSIONS This case report presents an atypical teratoid/rhabdoid tumor with initial gangligioma-like differentiation. This study adds to the data in the literature and promotes the study of this type of histogenesis. It lays a foundation for encouraging further studies to determine whether changes should be made to existing management protocols and, at the same time, determine whether there would be any variation with regard to disease prognosis.
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Affiliation(s)
- Juan Alberto Paz-Archila
- Departamento de Neurocirugía, Hospital Roosevelt, Ciudad de Guatemala, Guatemala; Departamento de Neurocirugía, Universidade Federal de São Paulo, São Paulo, Brasil.
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8
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Chen F, Mei W, Lu W, Zeng T, Kang D, Wu X, You H. Atypical Teratoid/Rhabdoid Tumor Originated From the Trigeminal Nerve in a Young Male Adult: Case Report and Review of the Literature. Front Neurol 2020; 11:265. [PMID: 32373048 PMCID: PMC7186469 DOI: 10.3389/fneur.2020.00265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 03/20/2020] [Indexed: 11/17/2022] Open
Abstract
Atypical teratoid/rhabdoid tumor (AT/RT) is a highly malignant central nervous system neoplasm predominantly found in children under the age of 3 years, and is extremely rare in adults. There is no specific clinical presentations or radiological features in reported cases of AT/RT. Diagnosis of brain AT/RT is mainly dependent on the classical pathological characteristics. We report a rare case of AT/RT arising from the trigeminal nerve and leading to progressively multiple cranial nerve palsies in a 25-year-old male patient. Microsurgical resection of the tumor has been performed and confirmed the diagnosis by postoperative pathology. To our knowledge, this is the second case of adult-onset AT/RT originating from the trigeminal nerve.
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Affiliation(s)
- Fuxiang Chen
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wenzhong Mei
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wen Lu
- Department of Disease Prevention and Healthcare, Fujian Provincial Hospital, Fuzhou, China
| | - Tiefa Zeng
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Dezhi Kang
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xiyue Wu
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Honghai You
- Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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9
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Nobusawa S, Nakata S, Yoshida Y, Yamazaki T, Ueki K, Amano K, Yamamoto J, Miyahara M, Sugai T, Nakazato Y, Hirato J, Yokoo H. Secondary INI1-deficient rhabdoid tumors of the central nervous system: analysis of four cases and literature review. Virchows Arch 2019; 476:763-772. [PMID: 31707588 DOI: 10.1007/s00428-019-02686-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/09/2019] [Accepted: 10/09/2019] [Indexed: 10/25/2022]
Abstract
Atypical teratoid/rhabdoid tumors (AT/RT) are rare, highly malignant neoplasms of the central nervous system that predominantly occur in infants, and are characterized by the presence of rhabdoid cells and inactivation of INI1 or (extremely rarely) BRG1. The vast majority of AT/RT are recognized as primary tumors; however, rare AT/RT or INI1-deficient RT arising from other primary tumors have been reported. To better characterize secondary RT, we performed a histological and molecular analysis of four RT arising from pleomorphic xanthoastrocytoma (PXA), anaplastic PXA, low-grade astrocytoma, or ependymoma. Histologically, although conventional AT/RT are usually not largely composed of rhabdoid cells, three secondary RT were composed mainly of rhabdoid cells, two of which arising from (anaplastic) PXA exhibited marked nuclear pleomorphism reminiscent of that in the precursor lesions. Regarding INI1 alterations, although mutations including small indels are frequent in conventional AT/RT, only in one secondary RT had a mutation. Moreover, together with previously reported cases, biallelic INI1 inactivation in secondary RT was mostly due to biallelic focal and/or broad deletions. Although conventional AT/RT have stable chromosomal profiles, i.e., the frequency of copy number changes involving chromosomes other than chromosome 22 is remarkably low, our array comparative genomic hybridization analysis revealed numerous copy number changes in the secondary RT. In conclusion, secondary RT of the central nervous system are clinicopathologically and molecularly different from conventional pediatric AT/RT, and a nosological issue is whether these secondary RT should be called secondary "AT/RT" as most of the reported cases were.
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Affiliation(s)
- Sumihito Nobusawa
- Department of Human Pathology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Satoshi Nakata
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Yuka Yoshida
- Department of Human Pathology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Tatsuya Yamazaki
- Department of Human Pathology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Keisuke Ueki
- Department of Neurosurgery, Dokkyo Medical University Hospital, Mibu, Japan
| | - Keishiro Amano
- Department of Pediatrics, Mie University Graduate School of Medicine, Tsu, Japan
| | - Junkoh Yamamoto
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Makiko Miyahara
- Department of Neurosurgery, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tsutomu Sugai
- Department of Neurosurgery, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | | | - Junko Hirato
- Department of Human Pathology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.,Department of Pathology, Public Tomioka General Hospital, Tomioka, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan
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10
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Sali AP, Chaubey V, Kodare D, Sahay A, Epari S. The Rare Phenomenon of Loss of INI1 Expression at Recurrence/Progression of Primary Central Nervous System Tumors: Report of 3 Cases. Int J Surg Pathol 2019; 28:341-347. [DOI: 10.1177/1066896919883942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
It is extremely rare for loss of immunohistochemical expression of INI1 to occur primarily at recurrence/progression with retained expression at the primary/initial presentation of central nervous system (CNS) tumor. In this article, we present 3 such cases showing loss of INI1 expression primarily at recurrence. All patients were males, aged 7 years (case 1), 11 years (case 2), and 35 years (case 3), diagnosed with low-grade glial/glioneuronal tumor, not otherwise specified (case 1), craniopharyngioma (case 2), and glioblastoma (case 3); all showed retained INI1 protein expression. Case 1 at 12 months recurrence showed a high-grade tumor with relative undifferentiated morphology, case 2 after 104 months showed a sarcomatous progression, and case 3 recurred after 4 months with the presence of relative undifferentiated round cells. All these recurrences showed loss of INI1 expression. Loss of SMARCB1/INI1 gene function resulting in complete loss of INI1 protein expression is not a well-accepted genetic mechanism for transformation/progression as this series emphasizes.
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Affiliation(s)
- Akash Pramod Sali
- Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vishal Chaubey
- Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Duhita Kodare
- Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Ayushi Sahay
- Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sridhar Epari
- Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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11
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Rossi S, Brenca M, Zanatta L, Trincia E, Guerriero A, Pizzato C, Fiorindi A, Viscardi E, Giangaspero F, Maestro R, Dei Tos AP, Giannini C. A Pediatric Intra-Axial Malignant SMARCB1-Deficient Desmoplastic Tumor Arising in Meningioangiomatosis. J Neuropathol Exp Neurol 2019; 77:883-889. [PMID: 30169623 DOI: 10.1093/jnen/nly075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
SMARCB1 inactivation is a well-established trigger event in atypical teratoid/rhabdoid tumor. Recently, a role for SMARCB1 inactivation has emerged as a mechanism of clonal evolution in other tumor types, including rare brain tumors. We describe an unusual malignant intra-axial SMARCB1-deficient spindle cell desmoplastic neoplasm, occurring in a 6-year-old child with meningioangiomatosis and a long history of seizures. Striking features of the tumor were a storiform pattern and strong CD34 expression. Undifferentiated round cell areas with isolated rhabdoid cells showing high mitotic index and focal necrosis with INI1 expression loss were present. The meningioangiomatosis component showed few chromosomal imbalances, including chromosomal 22 monosomy (where SMARCB1 maps) and gain at 6q14.3. In addition to these abnormalities, the spindle cell desmoplastic neoplasm and its dedifferentiated SMARCB1-deficient component shared several other aberrations, including homozygous deletion at 9p21.3, losses at 1p, 3p, 3q, 10p, and 13q, gains and losses at 5p and 11p. In line with INI1 loss, the dedifferentiated component showed remarkably decreased levels of SMARCB1 transcript. The residual SMARCB1 allele was wildtype. Our findings suggest progression from the meningioangiomatosis to the malignant desmoplastic neoplasm through the occurrence of complex chromosomal abnormalities, and point to functional silencing of SMARCB1 in the dedifferentiation component.
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Affiliation(s)
- Sabrina Rossi
- Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy
| | - Monica Brenca
- Experimental Oncology, CRO Aviano IRCCS National Cancer Institute, Aviano, Italy
| | - Lucia Zanatta
- Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy
| | | | - Angela Guerriero
- Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy
| | - Cristina Pizzato
- Department of Paediatrics, Treviso General Hospital, Treviso, Italy
| | - Alessandro Fiorindi
- Department of Neurosurgery, Treviso General Hospital - Padova University, Italy
| | - Elisabetta Viscardi
- Pediatric Hematology and Oncology, Department of Women's and Children's Health, University of Padova, Padova, Italy
| | - Felice Giangaspero
- Department of Radiology, Oncology and Anatomic Pathology, University La Sapienza, Rome, Italy.,Department of Neuropathology, IRCCS Neuromed, Pozzilli, Isernia, Italy
| | - Roberta Maestro
- Experimental Oncology, CRO Aviano IRCCS National Cancer Institute, Aviano, Italy
| | - Angelo Paolo Dei Tos
- Department of Pathology and Molecular Genetics, Treviso General Hospital, Treviso, Italy.,Department of Medicine, University of Padova School of Medicine, Padova, Italy
| | - Caterina Giannini
- Anatomic Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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12
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Zahedi S, Fitzwalter BE, Morin A, Grob S, Desmarais M, Nellan A, Green AL, Vibhakar R, Hankinson TC, Foreman NK, Mulcahy Levy JM. Effect of early-stage autophagy inhibition in BRAF V600E autophagy-dependent brain tumor cells. Cell Death Dis 2019; 10:679. [PMID: 31515514 PMCID: PMC6742667 DOI: 10.1038/s41419-019-1880-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 08/06/2019] [Accepted: 08/20/2019] [Indexed: 12/27/2022]
Abstract
Autophagy is a multistage process. Progress within the field has led to the development of agents targeting both early (initiation) and late (fusion) stages of this process. The specific stage of autophagy targeted may influence cancer treatment outcomes. We have previously shown that central nervous system (CNS) tumors with the BRAFV600E mutation are autophagy dependent, and late-stage autophagy inhibition improves the response to targeted BRAF inhibitors (BRAFi) in sensitive and resistant cells. Drugs directed toward initiation of autophagy have been shown to reduce tumor cell death in some cancers, but have not been assessed in CNS tumors. We investigated early-stage inhibition for autophagy-dependent CNS tumors. BRAFi-sensitive and resistant AM38 and MAF794 cell lines were evaluated for the response to pharmacologic and genetic inhibition of ULK1 and VPS34, two crucial subunits of the autophagy initiation complexes. Changes in autophagy were monitored by western blot and flow cytometry. Survival was evaluated in short- and long-term growth assays. Tumor cells exhibited a reduced autophagic flux with pharmacologic and genetic inhibition of ULK1 or VPS34. Pharmacologic inhibition reduced cell survival in a dose-dependent manner for both targets. Genetic inhibition reduced cell survival and confirmed that it was an autophagy-specific effect. Pharmacologic and genetic inhibition were also synergistic with BRAFi, irrespective of RAFi sensitivity. Inhibition of ULK1 and VPS34 are potentially viable clinical targets in autophagy-dependent CNS tumors. Further evaluation is needed to determine if early-stage autophagy inhibition is equal to late-stage inhibition to determine the optimal clinical target for patients.
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Affiliation(s)
- Shadi Zahedi
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Brent E Fitzwalter
- Department of Pharmacology, University of Colorado Denver, Aurora, CO, USA
| | - Andrew Morin
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Sydney Grob
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Michele Desmarais
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Anandani Nellan
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Adam L Green
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Rajeev Vibhakar
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Todd C Hankinson
- The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA.,Department of Neurosurgery, University of Colorado Denver, Aurora, CO, USA
| | - Nicholas K Foreman
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA.,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA
| | - Jean M Mulcahy Levy
- Department of Pediatrics, University of Colorado Denver, Aurora, CO, USA. .,The Morgan Adams Foundation Pediatric Brain Tumor Research Program, Children's Hospital Colorado, Aurora, CO, USA. .,Department of Pharmacology, University of Colorado Denver, Aurora, CO, USA.
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13
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Scheie D, Kufaishi HHA, Broholm H, Lund EL, de Stricker K, Melchior LC, Grauslund M. Biomarkers in tumors of the central nervous system - a review. APMIS 2019; 127:265-287. [PMID: 30740783 DOI: 10.1111/apm.12916] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 12/07/2018] [Indexed: 12/21/2022]
Abstract
Until recently, diagnostics of brain tumors were almost solely based on morphology and immunohistochemical stainings for relatively unspecific lineage markers. Although certain molecular markers have been known for longer than a decade (combined loss of chromosome 1p and 19q in oligodendrogliomas), molecular biomarkers were not included in the WHO scheme until 2016. Now, the classification of diffuse gliomas rests on an integration of morphology and molecular results. Also, for many other central nervous system tumor entities, specific diagnostic, prognostic and predictive biomarkers have been detected and continue to emerge. Previously, we considered brain tumors with similar histology to represent a single disease entity. We now realize that histologically identical tumors might show alterations in different molecular pathways, and often represent separate diseases with different natural history and response to treatment. Hence, knowledge about specific biomarkers is of great importance for individualized treatment and follow-up. In this paper we review the biomarkers that we currently use in the diagnostic work-up of brain tumors.
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Affiliation(s)
- David Scheie
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | | | - Helle Broholm
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Eva Løbner Lund
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Morten Grauslund
- Department of Genetics and Pathology, Laboratory Medicine, Lund, Sweden
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14
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Sellar Region Atypical Teratoid/Rhabdoid Tumors (ATRT) in Adults Display DNA Methylation Profiles of the ATRT-MYC Subgroup. Am J Surg Pathol 2018; 42:506-511. [DOI: 10.1097/pas.0000000000001023] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Abstract
The SWItch Sucrose non-fermentable (SWI/SNF) complex is a highly conserved multi-subunit complex of proteins encoded by numerous genes mapped to different chromosomal regions. The complex regulates the process of chromatin remodelling and hence plays a central role in the epigenetic regulation of gene expression, cell proliferation and differentiation. During the last three decades, the SWI/SNF complex has been increasingly recognized as a central molecular event driving the initiation and/or progression of several benign and malignant neoplasms of different anatomic origin and having diverse histomorphological appearance. Atypical teratoid/rhabdoid tumors (AT/RT) and renal/extrarenal malignant rhabdoid tumors of childhood, epithelioid sarcoma and small cell carcinoma of the ovary, hypercalcemic type (SCCOHT) represent the most commonly recognized SWI/SNF-driven neoplasms. Approximately one-third of pediatric malignant rhabdoid tumors are linked to germline SWI/SNF alterations (SMARCB1/INI1, rarely SMARCA4) resulting in occasional familial clustering of these highly aggressive malignancies (so-called rhabdoid tumor predisposition syndrome, RTPS, types 1 and 2, respectively). However, more recently, inherited SWI/SNF-deficiency has been linked to several benign syndromic tumors including a subset of familial schwannomatosis (linked to SMARCB1) and multiple meningiomas (linked to SMARCE1) as well as others. Beyond neoplasms, several congenital developmental functional disorders such as Coffin-Siris syndrome and intellectual disability are now known to be SWI/SNF-related. The latter are essentially not associated with SWI/SNF-driven neoplasms, although at least anecdotal cases have documented concurrence of both neoplastic and developmental disorders. This review summarizes the most important SWI/SNF-driven diseases with a main focus on neoplasms.
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen, Germany.
| | - William D Foulkes
- Departments of Human Genetics, Medicine and Oncology, McGill University, Montreal, Quebec, Canada
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16
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Barresi V, Lionti S, Raso A, Esposito F, Cannavò S, Angileri FF. Pituitary atypical teratoid rhabdoid tumor in a patient with prolactinoma: A unique description. Neuropathology 2017; 38:260-267. [DOI: 10.1111/neup.12440] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/04/2017] [Accepted: 10/04/2017] [Indexed: 12/14/2022]
Affiliation(s)
- Valeria Barresi
- Department of Human Pathology in Adulthood and Evolutive Age; University of Messina; Messina Italy
| | - Simona Lionti
- Department of Human Pathology in Adulthood and Evolutive Age; University of Messina; Messina Italy
| | - Alessandro Raso
- Unit of Neurosurgery; Giannina Gaslini Institute; Genoa Italy
| | - Felice Esposito
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging; University of Messina; Messina Italy
| | - Salvatore Cannavò
- Department of Human Pathology in Adulthood and Evolutive Age; University of Messina; Messina Italy
| | - Filippo F. Angileri
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging; University of Messina; Messina Italy
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17
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Schweizer Y, Meszaros Z, Jones DT, Koelsche C, Boudalil M, Fiesel P, Schrimpf D, Piro RM, Brehmer S, von Deimling A, Kerl U, Seiz-Rosenhagen M, Capper D. Molecular Transition of an Adult Low-Grade Brain Tumor to an Atypical Teratoid/Rhabdoid Tumor Over a Time-Course of 14 Years. J Neuropathol Exp Neurol 2017; 76:655-664. [DOI: 10.1093/jnen/nlx044] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Lach B, Kameda-Smith M, Singh S, Ajani O. Development of an Atypical Teratoid Rhabdoid Tumor in a Meningioma. Int J Surg Pathol 2017; 25:567-572. [DOI: 10.1177/1066896917707039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We describe an atypical teratoid rhabdoid tumor (AT/RT) with a component of low-grade and anaplastic rhabdoid meningioma in a 7-year-old child. The AT/RT was uniformly negative for INI1 and displayed immunoreactivity for vimentin, P53, CD99, cytokeratins with AE1/AE3 antibodies, epithelial membrane antigen, β-catenin, smooth muscle actin, E-cadherin, and S-100 protein. AT/RT was continuous, with small foci of recognizable low-grade and anaplastic meningioma. The low-grade meningioma was INI1 positive with scattered INI1-negative nuclei, whereas the remaining tumor components were INI1 negative. A recurrent tumor 6 months after partial resection contained only INI1-negative AT/RT. This case supports the hypothesis that rare examples of AT/RT may emerge from a preexisting “parent” neoplasm as a result of a second hit mutation.
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Affiliation(s)
- Boleslaw Lach
- Hamilton Health Sciences, Hamilton General Site, Hamilton, ON, Canada
| | | | - Sheila Singh
- McMaster Children’s Hospital, Hamilton, ON, Canada
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19
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Bozzai B, Hasselblatt M, Turányi E, Frühwald MC, Siebert R, Bens S, Schneppenheim R, Kool M, Stelczer G, Hortobágyi T, Hauser P. Atypical teratoid/rhabdoid tumor arising in a malignant glioma. Pediatr Blood Cancer 2017; 64:96-99. [PMID: 27472468 DOI: 10.1002/pbc.26173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2016] [Revised: 06/06/2016] [Accepted: 07/01/2016] [Indexed: 11/07/2022]
Abstract
Atypical teratoid/rhabdoid tumor (AT/RT), a highly malignant brain tumor in young children, usually arises de novo and has only rarely been described as a secondary malignancy. Here, we present a case of a child with glioblastoma, who was treated postoperatively by a combination of temozolomide, irradiation, and bevacizumab. AT/RT was diagnosed as a secondary tumor, 2.5 years following primary diagnosis. The child died 13 months after the diagnosis of AT/RT. This case demonstrates that malignant gliomas may give rise to AT/RT. It also emphasizes the diagnostic value of a repeated tumor biopsy in the recurrence setting.
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Affiliation(s)
- Barbara Bozzai
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Martin Hasselblatt
- Department of Neuropathology, Institute of Neuropathology, University Hospital Münster, Münster, Germany
| | - Eszter Turányi
- 1st Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary
| | - Michael C Frühwald
- Department of Oncology, Children's Hospital and Swabian Children's Cancer Center, Augsburg, Germany
| | - Reiner Siebert
- Department of Human Genetics, Institute of Human Genetics, Christian-Albrechts-University Kiel, Kiel, Germany
- Department of Human Genetics, Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Susanne Bens
- Department of Human Genetics, Institute of Human Genetics, Christian-Albrechts-University Kiel, Kiel, Germany
- Department of Human Genetics, Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Reinhard Schneppenheim
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcel Kool
- Division of Pediatric Neurooncology, German Cancer Research Center DKFZ, Heidelberg, Germany
- German Cancer Consortium, Core Center Heidelberg, Heidelberg, Germany
| | - Gábor Stelczer
- Department of Radiotherapy, National Institute of Oncology, Budapest, Hungary
| | - Tibor Hortobágyi
- Division of Neuropathology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Peter Hauser
- 2nd Department of Pediatrics, Semmelweis University, Budapest, Hungary
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20
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21
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Nobusawa S, Hirato J, Sugai T, Okura N, Yamazaki T, Yamada S, Ikota H, Nakazato Y, Yokoo H. Atypical Teratoid/Rhabdoid Tumor (AT/RT) Arising From Ependymoma: A Type of AT/RT Secondarily Developing From Other Primary Central Nervous System Tumors. J Neuropathol Exp Neurol 2016; 75:167-74. [PMID: 26769252 DOI: 10.1093/jnen/nlv017] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Atypical teratoid/rhabdoid tumors (AT/RT) are rare, aggressive, embryonal brain tumors that occur most frequently in very young children; they are characterized by rhabdoid cells and loss of INI1 protein nuclear expression. Here, we report the case of a 24-year-old man with a left frontal lobe tumor that was composed mainly of rhabdoid cells showing loss of INI1 nuclear reactivity and polyphenotypic immunohistochemical expression, with a small INI1-positive component of ependymoma. Array comparative genomic hybridization separately conducted for each histologically distinct component revealed 22 shared identical copy number alterations, including loss of heterozygosity of chromosome 22q containing the INI1 locus. Furthermore, we found the C11orf95-RELA fusion gene, the genetic hallmark of supratentorial ependymomas, not only in the ependymoma component but also in the AT/RT component by fluorescence in situ hybridization analysis, suggesting that the AT/RT cells secondarily progressed from the preexisting ependymoma cells. A second genetic inactivating event in the INI1 gene was not detected in the AT/RT component. There are several reported cases of AT/RT (or INI1-negative rhabdoid tumors) arising in the setting of other primary brain tumors (gangliogliomas, pleomorphic xanthoastrocytomas, and high-grade gliomas), but the present case
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22
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Patibandla MR, Ridder T, Dorris K, Torok MR, Liu AK, Handler MH, Stence NV, Fenton LZ, Hankinson TC. Atypical pediatric ganglioglioma is common and associated with a less favorable clinical course. J Neurosurg Pediatr 2016; 17:41-8. [PMID: 26431248 DOI: 10.3171/2015.6.peds15215] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECT Ganglioglioma (GG) is commonly recognized as a low-grade tumor located in the temporal lobe, often presenting with seizures. Most are amenable to complete resection and are associated with excellent oncological outcome. The authors encountered several GGs in various locations, which seem to have a less favorable clinical course than GGs in the temporal lobe. METHODS The authors performed a single-center retrospective review of all children with a histological diagnosis of GG who were treated at Children's Hospital Colorado between 1997 and 2013. Each tumor was categorized by 2 pediatric neuroradiologists as typical or atypical based on preoperative MRI appearance. Typical lesions were cortically based, within a single cerebral lobe, well-circumscribed, and solid or mixed solid/cystic. The treatment and clinical course of each patient was analyzed. RESULTS Thirty-seven children were identified, with a median age at presentation of 8.2 years and median follow-up of 38.0 months. Eighteen tumors (48.6%) were typical and 19 (51.4%) were atypical. All typical lesions presented with seizures, whereas no atypical lesions did so. Sixteen (88.9%) typical lesions were located in the temporal lobe. In the atypical group, tumor location was variable, including 11 (57.9%) in the brainstem. Death during follow-up was statistically more common in the atypical group (31.6% vs 0%, p = 0.02). Gross-total resection (GTR) was achieved for 15 of 16 typical tumors (93.8%), compared with 3 atypical tumors (15.8%, p < 0.0001). Presentation with seizure or non-brainstem location were each associated with survival (p = 0.02 and 0.004, respectively). The presence of mutation in BRAF exon 15 did not differ between the 2 groups. CONCLUSIONS Pediatric GG with typical imaging features is associated with excellent rates of GTR and overall survival. Atypical GG is commonly encountered, less amenable to GTR, and associated with a worse outcome. This may relate to anatomical or biological characteristics and merits further investigation.
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Affiliation(s)
| | | | | | - Michelle R Torok
- Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | | | - Nicholas V Stence
- Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus; and
| | - Laura Z Fenton
- Radiology, Children's Hospital Colorado, University of Colorado Anschutz Medical Campus; and
| | - Todd C Hankinson
- Pediatric Neurosurgery;,Adult and Child Center for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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23
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Jamshidi F, Bashashati A, Shumansky K, Dickson B, Gokgoz N, Wunder JS, Andrulis IL, Lazar AJ, Shah SP, Huntsman DG, Nielsen TO. The genomic landscape of epithelioid sarcoma cell lines and tumours. J Pathol 2015; 238:63-73. [PMID: 26365879 DOI: 10.1002/path.4636] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 08/22/2015] [Accepted: 09/07/2015] [Indexed: 12/15/2022]
Abstract
We carried out whole genome and transcriptome sequencing on four tumour/normal pairs of epithelioid sarcoma. These index cases were supplemented with whole transcriptome sequencing of three additional tumours and three cell lines. Unlike rhabdoid tumour (the other major group of SMARCB1-negative cancers), epithelioid sarcoma shows a complex genome with a higher mutational rate, comparable to that of ovarian carcinoma. Despite this mutational burden, SMARCB1 mutations remain the most frequently recurring event and are probably critical drivers of tumour formation. Several cases show heterozygous SMARCB1 mutations without inactivation of the second allele, and we explore this further in vitro. Finding CDKN2A deletions in our discovery cohort, we evaluated CDKN2A protein expression in a tissue microarray. Six out of 16 cases had lost CDKN2A in greater than or equal to 90% of cells, while the remaining cases had retained the protein. Expression analysis of epithelioid sarcoma cell lines by transcriptome sequencing shows a unique profile that does not cluster with any particular tissue type or with other SWI/SNF-aberrant lines. Evaluation of the levels of members of the SWI/SNF complex other than SMARCB1 revealed that these proteins are expressed as part of a residual complex, similarly to previously studied rhabdoid tumour lines. This residual SWI/SNF is susceptible to synthetic lethality and may therefore indicate a therapeutic opportunity.
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Affiliation(s)
| | | | | | - Brendan Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Nalan Gokgoz
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Jay S Wunder
- Division of Orthopaedic Surgery, University of Toronto, ON, Canada
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.,Departments of Molecular Genetics and Laboratory Medicine and Pathobiology, University of Toronto, ON, Canada
| | | | - Sohrab P Shah
- BC Cancer Research Centre, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada.,Department of Molecular Oncology, BC Cancer Agency, Vancouver, BC, Canada
| | - David G Huntsman
- Genetic Pathology Evaluation Centre, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Torsten O Nielsen
- Genetic Pathology Evaluation Centre, Vancouver, BC, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
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Hirose T, Nobusawa S, Kusanishi H. Ovarian primitive-type neuroectodermal tumour composed of desmoplastic/nodular medulloblastoma-like and atypical teratoid/rhabdoid tumour components. Histopathology 2015; 68:939-42. [PMID: 26383534 DOI: 10.1111/his.12864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Takanori Hirose
- Department of Pathology for Regional Communication, Kobe University Graduate School of Medicine, Kobe, Japan.,Diagnostic Pathology, Hyogo Cancer Centre, Akashi, Japan
| | - Sumihito Nobusawa
- Department of Human Pathology, Gunma University Graduate School of Medicine, Maebashi, Japan
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25
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Stockman DL, Curry JL, Torres-Cabala CA, Watson IR, Siroy AE, Bassett RL, Zou L, Patel KP, Luthra R, Davies MA, Wargo JA, Routbort MA, Broaddus RR, Prieto VG, Lazar AJ, Tetzlaff MT. Use of clinical next-generation sequencing to identify melanomas harboringSMARCB1mutations. J Cutan Pathol 2015; 42:308-17. [DOI: 10.1111/cup.12481] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 02/01/2015] [Indexed: 12/26/2022]
Affiliation(s)
- David L. Stockman
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Jonathan L. Curry
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Carlos A. Torres-Cabala
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Ian R. Watson
- Department of Genomic Medicine; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Alan E. Siroy
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Roland L. Bassett
- Department of Biostatistics; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Lihua Zou
- The Eli and Edythe L. Broad Institute of Massachusetts; Institute of Technology and Harvard University; Cambridge Massachusetts USA
| | - Keyur P. Patel
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Rajyalakshmi Luthra
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Michael A. Davies
- Department of Melanoma Medical Oncology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Jennifer A. Wargo
- Department of Surgery; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Mark A. Routbort
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Russell R. Broaddus
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Victor G. Prieto
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Alexander J. Lazar
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
| | - Michael T. Tetzlaff
- Department of Pathology and Laboratory Medicine, Section of Dermatopathology; The University of Texas MD Anderson Cancer Center; Houston TX USA
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26
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Broniscer A, Tatevossian RG, Sabin ND, Klimo P, Dalton J, Lee R, Gajjar A, Ellison DW. Clinical, radiological, histological and molecular characteristics of paediatric epithelioid glioblastoma. Neuropathol Appl Neurobiol 2014; 40:327-36. [PMID: 24127995 DOI: 10.1111/nan.12093] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 10/08/2013] [Indexed: 11/29/2022]
Abstract
AIMS A few case series in adults have described the characteristics of epithelioid glioblastoma (e-GB), one of the rarest variants of this cancer. We evaluated clinical, radiological, histological and molecular characteristics in the largest series to date of paediatric e-GB. METHODS Review of clinical characteristics and therapy, imaging studies and histology was performed in patients younger than 22 years with e-GB seen at our institution over 15 years. Sequencing of hotspot mutations and fluorescence in situ hybridization of relevant genes were undertaken. RESULTS Median age at diagnosis of six patients was 7.6 years. Tumours originated in the cerebral cortex (n = 2) or diencephalon (n = 4). Three patients presented with acute, massive haemorrhage and three had leptomeningeal dissemination at diagnosis. Paediatric e-GB had the typical histological characteristics seen in adult tumours. Universal immunoreactivity for INI1 and lack of diverse protein expression were seen in all cases. One tumour had a chromosome 22q loss. Three tumours (50%) harboured a BRAF: p.V600E. One thalamic tumour had an H3F3A p.K27M. All patients received radiation therapy with (n = 3) or without chemotherapy (n = 3). All patients experienced tumour progression with a median survival of 169 days. One patient with nonmetastatic disease had early leptomeningeal progression. Two patients had symptomatic tumour spread outside the central nervous system (CNS) through a ventriculoperitoneal shunt. One additional patient had widespread metastases outside the CNS identified at autopsy. CONCLUSIONS Paediatric e-GBs are rare cancers with an aggressive behaviour that share histological and genetic characteristics with their adult counterparts. BRAF inhibition is a potential treatment for these tumours.
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Affiliation(s)
- A Broniscer
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
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The expanding family of SMARCB1(INI1)-deficient neoplasia: implications of phenotypic, biological, and molecular heterogeneity. Adv Anat Pathol 2014; 21:394-410. [PMID: 25299309 DOI: 10.1097/pap.0000000000000038] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Since the description of atypical teratoid/rhabdoid tumors of the central nervous system and renal/extrarenal malignant rhabdoid tumors in children, the clinicopathologic spectrum of neoplasms having in common a highly variable rhabdoid cell component (0% to 100%) and consistent loss of nuclear SMARCB1 (INI1) expression has been steadily expanding to include cribriform neuroepithelial tumor of the ventricle, renal medullary carcinoma and a subset of collecting duct carcinoma, epithelioid sarcoma, subsets of miscellaneous benign and malignant soft tissue tumors, and rare rhabdoid carcinoma variants of gastroenteropancreatic, sinonasal, and genitourinary tract origin. Although a majority of SMARCB1-deficient neoplasms arise de novo, the origin of SMARCB1-deficient neoplasia in the background of a phenotypically or genetically definable differentiated SMARCB1-intact "parent neoplasm" has been convincingly demonstrated, highlighting the rare occurrence of rhabdoid tumors as "double-hit neoplasia." As a group, SMARCB1-deficient neoplasms occur over a wide age range (0 to 80 y), may be devoid of rhabdoid cells or display uniform rhabdoid morphology, and follow a clinical course that varies from benign to highly aggressive causing death within a few months irrespective of aggressive multimodality therapy. Generally applicable criteria that would permit easy recognition of these uncommon neoplasms do not exist. Diagnosis is based on site-specific and entity-specific sets of clinicopathologic, immunophenotypic, and/or molecular criteria. SMARCB1 immunohistochemistry has emerged as a valuable tool in confirming or screening for SMARCB1-deficient neoplasms. This review summarizes the different phenotypic and topographic subgroups of SMARCB1-deficient neoplasms including sporadic and familial, benign and malignant, and rhabdoid and nonrhabdoid variants, highlighting their phenotypic heterogeneity and molecular complexity.
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28
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Agaimy A, Koch M, Lell M, Semrau S, Dudek W, Wachter DL, Knöll A, Iro H, Haller F, Hartmann A. SMARCB1(INI1)-deficient sinonasal basaloid carcinoma: a novel member of the expanding family of SMARCB1-deficient neoplasms. Am J Surg Pathol 2014; 38:1274-81. [PMID: 24832165 PMCID: PMC4141899 DOI: 10.1097/pas.0000000000000236] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Poorly differentiated sinonasal carcinomas are a heterogenous group of aggressive neoplasms that encompasses squamous cell carcinoma including basaloid variant, lymphoepithelial carcinoma, sinonasal undifferentiated carcinoma, and neuroendocrine-type small cell carcinoma. We herein describe 3 cases of a hitherto unreported variant combining features of basaloid carcinoma with variable intermingled rhabdoid cells. Patients were 2 women (aged 28 and 35) and a man (52 y) who presented with sinonasal masses. All had advanced local disease with bone involvement (pT4). None had a history of irradiation or a family history of rhabdoid tumors. Treatment was surgery and adjuvant chemoradiation. One patient developed liver, lung, pleural, and pericardial metastases (63 mo) and is currently (70 mo) alive under palliative treatment. Another developed recurrent cervical lymph node metastases and died of disease 8.5 years later. The youngest patient was disease-free at last follow-up 7 years later. Histologic features were very similar in all 3 cases and showed intimate admixture of compact basaloid cell nests with peripheral palisading, perivascular pseudorosettes, and a few scattered rhabdoid cells. Rhabdoid cells were more extensive in the metastasis in 1 case but formed a minor inconspicuous component in the primary tumors in all cases. Striking features common to all cases were (1) basaloid “blue” appearance at low power, (2) papilloma-like exophytic component, (3) extensive pagetoid surface growth with prominent denuding features, and (4) replacement of underlying mucous glands mimicking an inverted papilloma. Clear-cut origin from benign papilloma and overt squamous differentiation were lacking. Diffuse (2) or partial (1) p16 expression was noted, but all cases lacked human papillomavirus DNA by molecular tests. In situ hybridization was negative for Epstein-Barr virus. Immunohistochemistry showed diffuse expression of pancytokeratin. CK5 and vimentin showed intermingling of CK5+/vimentin− basaloid and CK5−/vimentin+ rhabdoid cells. Complete loss of nuclear SMARCB1 expression was seen in all cases including also the denuding carcinoma in situ–like surface lesions. To our knowledge, this variant of sinonasal carcinoma has not been reported before. The identical features in all 3 cases suggest a specific disease rather than a nonspecific dedifferentiated phenotype. Awareness of this rare variant and thus reporting of additional cases is necessary for defining its full morphologic and biological spectrum.
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Affiliation(s)
- Abbas Agaimy
- *Institute of Pathology †Department of Otorhinolaryngology Head and Neck Surgery ‡Institute of Diagnostic and Interventional Radiology Departments of §Radiation Therapy ∥Thoracic Surgery ¶Institute of Virology, University Hospital of Erlangen, Erlangen, Germany
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29
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Bosse KR, Shukla AR, Pawel B, Chikwava KR, Santi M, Tooke L, Castagna K, Biegel JA, Bagatell R. Malignant rhabdoid tumor of the bladder and ganglioglioma in a 14 year-old male with a germline 22q11.2 deletion. Cancer Genet 2014; 207:415-9. [PMID: 25018128 PMCID: PMC7412592 DOI: 10.1016/j.cancergen.2014.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Revised: 05/04/2014] [Accepted: 05/10/2014] [Indexed: 12/21/2022]
Abstract
Malignant rhabdoid tumors (MRTs) are rare pediatric malignancies characterized by clinically aggressive lesions that typically show loss of SMARCB1 expression. We herein describe a case of a malignant rhabdoid tumor of the bladder in a 14-year-old male with an autism spectrum disorder and a de novo 3 Mb germline deletion in chromosome band 22q11.2 that included the SMARCB1 gene. The malignancy developed in the setting of chronic hematuria (>2 years) following the occurrence of two other lesions: a central nervous system ganglioglioma and an intraoral dermoid cyst. MRTs of the bladder are exceedingly rare, and this patient is the oldest child reported with this tumor to date. This case adds to the growing body of literature regarding the recently described, phenotypically diverse, distal 22q11.2 syndrome. Furthermore, this is the first reported case in which an MRT of the bladder appears to have developed from a pre-existing bladder lesion. Finally, this case further supports a rhabdoid tumorigenesis model in which heterozygous loss of SMARCB1 predisposes to initial tumor formation with intact SMARCB1 expression, with subsequent inactivation of the other SMARCB1 allele, which results in transformation into more malignant lesions.
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Affiliation(s)
- Kristopher R Bosse
- Division of Oncology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Aseem R Shukla
- Division of Urology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Bruce Pawel
- Department of Pathology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Kudakwashe R Chikwava
- Department of Pathology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Mariarita Santi
- Department of Pathology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Laura Tooke
- Department of Pathology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Katherine Castagna
- Department of Pathology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Jaclyn A Biegel
- Department of Pathology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | - Rochelle Bagatell
- Division of Oncology, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Pediatrics, The Children's Hospital of Philadelphia and the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA.
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30
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Levy JMM, Thompson JC, Griesinger AM, Amani V, Donson AM, Birks DK, Morgan MJ, Mirsky DM, Handler MH, Foreman NK, Thorburn A. Autophagy inhibition improves chemosensitivity in BRAF(V600E) brain tumors. Cancer Discov 2014; 4:773-80. [PMID: 24823863 DOI: 10.1158/2159-8290.cd-14-0049] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
UNLABELLED Autophagy inhibition is a potential therapeutic strategy in cancer, but it is unknown which tumors will benefit. The BRAF(V600E) mutation has been identified as important in pediatric central nervous system (CNS) tumors and is known to affect autophagy in other tumor types. We evaluated CNS tumor cells with BRAF(V600E) and found that mutant (but not wild-type) cells display high rates of induced autophagy, are sensitive to pharmacologic and genetic autophagy inhibition, and display synergy when the clinically used autophagy inhibitor chloroquine was combined with the RAF inhibitor vemurafenib or standard chemotherapeutics. Importantly, we also demonstrate that chloroquine can improve vemurafenib sensitivity in a resistant ex vivo primary culture and provide the first demonstration in a patient harboring the V600E mutation treated with vemurafenib that the addition of chloroquine can improve clinical outcomes. These findings suggest that CNS tumors with BRAF(V600E) are autophagy-dependent and should be targeted with autophagy inhibition in combination with other therapeutic strategies. SIGNIFICANCE Autophagy inhibition may improve cancer therapy, but it is unclear which tumors will benefit. We found that BRAF mutations cause brain tumor cells to depend on autophagy and display selective chemosensitization with autophagy inhibition. We present a pediatric case in which deliberate autophagy inhibition halted tumor growth and overcame acquired BRAF-inhibition resistance.
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Affiliation(s)
| | | | | | | | | | | | | | - David M Mirsky
- Radiology, University of Colorado Denver, Aurora, Colorado
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31
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Jeong JY, Suh YL, Hong S. Atypical teratoid/rhabdoid tumor arising in pleomorphic xanthoastrocytoma: A case report. Neuropathology 2014. [DOI: 10.1111/neup.12106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ji Yun Jeong
- Department of Pathology; Kyungpook National University Hospital; Kyungpook National University School of Medicine; Daegu Korea
| | - Yeon-Lim Suh
- Department of Pathology; Samsung Medical Center; Sungkyunkwan University School of Medicine; Seoul Korea
| | - SoonWon Hong
- Department of Pathology; Gangnam Severance Hospital; Yonsei University, College of Medicine; Seoul Korea
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32
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Aisner DL, Newell KL, Pollack AG, Kleinschmidt-DeMasters BK, Steinberg GK, Smyth LT, Vogel H. Composite pleomorphic xanthoastrocytoma-epithelioid glioneuronal tumor with BRAF V600E mutation - report of three cases. Clin Neuropathol 2014; 33:112-21. [PMID: 24321241 PMCID: PMC4594433 DOI: 10.5414/np300679] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 02/20/2014] [Indexed: 11/18/2022] Open
Abstract
We report three examples of a composite pleomorphic xanthoastrocytoma-epithelioid glioneuronal tumor (PXAEGT) occurring in an adolescent male and two young women. All were superficial and two were located in proximity to the optic nerves. Previously reported composite PXA-gangliogliomas (PXA-GG), have been considered "collision tumors" since little intermingling of the two elements has been present. In contrast, we hypothesized that the two elements of the PXA-EGT might instead derive from a common origin. To test this, we sampled the separate regions of these biphasic tumors and assessed each component for the BRAF V600E mutation, a genetic feature seen in two-thirds of pure PXAs. The BRAF mutation was found in both tumor areas in all cases, suggesting a common origin for the components, rather than a collision tumor. These biphasic PXA-EGT cases represent a new histomorphological combination of neuroepithelial neoplastic elements. These cases further expand the range of glial neoplasia in which epithelioid morphology is encountered, and add to the growing list of biphasic tumors harboring the BRAF V600E mutation.
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Affiliation(s)
| | | | - Ania G. Pollack
- Neurosurgery, University of Kansas Medical Center, Kansas City, KS
| | - Bette K. Kleinschmidt-DeMasters
- Departments of Pathology
- Neurology
- Neurosurgery at the Anschutz Medical Campus, University of Colorado at Denver, Aurora, CO, and Departments of
| | - Gary K. Steinberg
- Neurosurgery Stanford University, Palo Alto, CA, Department of Pathology, and
| | - Lawrence T. Smyth
- Kaiser Permanente Redwood City Medical Center, Redwood City, CA, USA
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33
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Krishnan C, Vogel H, Perry A. Atypical teratoid/rhabdoid tumor with ganglioglioma-like differentiation: case report and review of the literature. Hum Pathol 2013; 45:185-8. [PMID: 24034858 DOI: 10.1016/j.humpath.2013.07.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 07/29/2013] [Accepted: 07/31/2013] [Indexed: 10/26/2022]
Abstract
Atypical teratoid/rhabdoid tumor (AT/RT) is a highly aggressive embryonal tumor of the central nervous system, which typically affects young children. A characteristic feature of AT/RT is a polyphenotypic immunoprofile and ultrastructural diversity. The morphologic and antigenic heterogeneity of AT/RT give it the potential to mimic other embryonal central nervous system tumors, epithelial neoplasms or mesenchymal tumors. Alternatively, "collision-type" tumors have been published, in which AT/RT coexists with a separate low-grade central nervous system tumor. Here, we report a case of AT/RT with morphologic and immunohistochemical evidence of extensive ganglioglioma-like differentiation with only a small focal primitive component and minimal rhabdoid cytology. Fluorescence in situ hybridization and immunohistochemistry demonstrated INI1/BAF47 gene/protein losses in both histologic components. To the best of our knowledge, this is the first reported case of AT/RT with extensive ganglioglioma-like differentiation. This unique case supports the notion that routine application of INI1 stains/in situ hybridization can capture AT/RT with unexpected patterns of differentiation.
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Affiliation(s)
- Chandra Krishnan
- Department of Pathology, Dell Children's Medical Center, Austin, TX 78723, USA.
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Birks DK, Donson AM, Patel PR, Sufit A, Algar EM, Dunham C, Kleinschmidt-DeMasters BK, Handler MH, Vibhakar R, Foreman NK. Pediatric rhabdoid tumors of kidney and brain show many differences in gene expression but share dysregulation of cell cycle and epigenetic effector genes. Pediatr Blood Cancer 2013; 60:1095-102. [PMID: 23382118 PMCID: PMC4681512 DOI: 10.1002/pbc.24481] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 11/01/2012] [Indexed: 11/05/2022]
Abstract
BACKGROUND Rhabdoid tumors (RTs) are aggressive tumors of early childhood that occur most often in brain (AT/RTs) or kidney (KRTs). Regardless of location, they are characterized by loss of functional SMARCB1 protein, a component of the SWI/SNF chromatin remodeling complex. The aim of this study was to determine genes and biological process dysregulated in common to both AT/RTs and KRTs. PROCEDURE Gene expression for AT/RTs was compared to that of other brain tumors and normal brain using microarray data from our lab. Similar analysis was performed for KRTs and other kidney tumors and normal kidney using data from GEO. Dysregulated genes common to both analyses were analyzed for functional significance. RESULTS Unsupervised hierarchical clustering of RTs identified three major subsets: two comprised of AT/RTs, and one of KRTs. Compared to other tumors, 1,187, 663, and 539 genes were dysregulated in each subset, respectively. Only 14 dysregulated genes were common to all three subsets. Compared to normal tissue, 5,209, 4,275, and 2,841 genes were dysregulated in each subset, with an overlap of 610 dysregulated genes. Among these genes, processes associated with cell proliferation, MYC activation, and epigenetic dysregulation were common to all three RT subsets. CONCLUSIONS The low overlap of dysregulated genes in AT/RTs and KRTs suggests that factors in addition to SMARCB1 loss play a role in determining subsequent gene expression. Drugs which target cell cycle or epigenetic genes may be useful in all RTs. Additionally, targeted therapies tailored to specific RT subset molecular profiles should be considered.
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Affiliation(s)
- Diane K Birks
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado at Denver, Aurora, Colorado 80010, USA.
| | - Andrew M. Donson
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Children’s Hospital, Colorado, 13123 East 16th Avenue, Aurora, CO 80045
| | - Purvi R. Patel
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Children’s Hospital, Colorado, 13123 East 16th Avenue, Aurora, CO 80045
| | - Alexandra Sufit
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Children’s Hospital, Colorado, 13123 East 16th Avenue, Aurora, CO 80045
| | - Elizabeth M. Algar
- Molecular Oncology Laboratory, Murdoch Children’s Research Institute, Parkville, Australia,Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Parkville, Australia
| | - Christopher Dunham
- Division of Anatomic Pathology, Children’s and Women’s Health Centre of B.C., 4500 Oak St., Vancouver, British Columbia, Canada V6H 3N1
| | - B. K. Kleinschmidt-DeMasters
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Departments of Pathology and Neurology, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA
| | - Michael H. Handler
- Department of Neurosurgery, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Children’s Hospital, Colorado, 13123 East 16th Avenue, Aurora, CO 80045
| | - Rajeev Vibhakar
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Children’s Hospital, Colorado, 13123 East 16th Avenue, Aurora, CO 80045
| | - Nicholas K. Foreman
- Department of Pediatrics, Anschutz Medical Campus, University of Colorado at Denver, 12800 East 19 Avenue, Aurora, CO 80010, USA,Children’s Hospital, Colorado, 13123 East 16th Avenue, Aurora, CO 80045
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Kim JH, Huse JT, Huang Y, Lyden D, Greenfield JP. Molecular diagnostics in paediatric glial tumours. Lancet Oncol 2013; 14:e19-27. [PMID: 23276367 DOI: 10.1016/s1470-2045(12)70577-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Glial tumours in children have distinct patterns of epigenetic alteration, chromosomal structure, and gene and protein expression that differentiate them from their histological counterparts in adults. Understanding paediatric gliomas at the molecular level provides important prognostic and therapeutic insights, such as which genetic alterations confer a favourable response to adjuvant therapy, or which signalling pathways might be amenable to specific molecularly targeted agents. For clinicians, the ultimate goal is to individualise therapeutic regimens on the basis of the molecular fingerprint of a particular tumour and the prognosis conferred by this profile. In this Review, we examine a series of studies of molecular and genomic analysis of glial tumours in children, and discuss the many clinical insights that these molecular features provide.
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Affiliation(s)
- Joon-Hyung Kim
- Department of Neurological Surgery, Weill Cornell Medical College, New York, NY 10065, USA
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