1
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A. Jacobo J. Central nervous system tumors of uncertain differentiation. World Neurosurg X 2024; 22:100349. [PMID: 38455248 PMCID: PMC10918257 DOI: 10.1016/j.wnsx.2024.100349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 12/05/2023] [Accepted: 02/21/2024] [Indexed: 03/09/2024] Open
Abstract
Background The 2021 World Health Organization classification for brain tumors introduced several new entities and categories.Tumors of uncertain differentiation are a new subcategory that includes the intracranial mesenchymal tumor, FET-CREB fusion-positive; the CIC-rearranged sarcoma; and the Primary intracranial sarcoma, DICER1-mutant. Methods A search was made in Pubmed and Google Scholar to include all articles with the term "uncertain differentiation", "Mesenchymal, non-meningothelial", "FET-CREB fusion positive", "DICER1-mutant sarcoma" and "CIC-Rearranged sarcoma" in their title. These articles were reviewed to draft a concise review on this subject. Results This review on CNS non-meningothelial mesenchymal tumors is meant to provide an update with diagnostic, prognostic, and therapeutic implications. Conclusion Tumors of uncertain differentiation include a variety of mesenchymal, non-meningothelial tumors that have distinct molecular characteristics and consequently behave in a very particular matter.Given that these tumors have been described only recently, there is still an important lack of information regarding the most appropriate treatment and prognosis.
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Affiliation(s)
- Javier A. Jacobo
- Neuro-Oncology Unit, Center for the Treatment and Investigation About Cancer (CTIC), Bogotá, Colombia
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2
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Vargas AC, Joy C, Maclean FM, Bonar F, Wong DD, Gill AJ, Cheah AL. Kinase expression in angiomatoid fibrous histiocytoma: panTRK is commonly expressed in the absence of NTRK rearrangement. J Clin Pathol 2024; 77:251-254. [PMID: 38053271 DOI: 10.1136/jcp-2023-209225] [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: 10/09/2023] [Accepted: 11/12/2023] [Indexed: 12/07/2023]
Abstract
Angiomatoid fibrous histiocytoma (AFH) is a soft tissue tumour of intermediate (rarely metastasising) malignant potential, which harbours EWSR1/FUS gene fusions. These tumours can express anaplastic lymphoma kinase (ALK) in the absence of gene rearrangement or copy number alteration and can also coexpresses Pan-TRK immunohistochemistry (IHC). All EWSR1/FUS-rearranged AFH were retrieved from the files of three institutions and Pan-TRK (EPR17341), ALK and BRAF V600E IHC were performed. Fourteen AFH cases were identified, which included three cases of intracranial mesenchymal tumours with FET-CREB fusions. PanTRK and ALK positive immunostaining was identified in 9 (64.2%) and 12 (85.7%) cases, respectively. No NTRK or ALK translocations or increased copy number/amplification were identified in all eight cases which had fluorescence in situ hybridisation and/or next generation sequencing for NTRK1-3 and ALK available for assessment. None of the cases expressed BRAF-V600E.Although our study is limited, our report is the first to document PanTRK expression in AFH in the absence of identifiable NTRK1-3 gene alterations.
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Affiliation(s)
- Ana Cristina Vargas
- The University of Sydney, Sydney, New South Wales, Australia
- Douglass Hanly Moir Pathology, North Ryde, New South Wales, Australia
| | - Christopher Joy
- Sullivan Nicolaides Pathology Central Laboratory Bowen Hills, Fortitude Valley, Queensland, Australia
| | - Fiona M Maclean
- Douglass Hanly Moir Pathology, North Ryde, New South Wales, Australia
| | - Fiona Bonar
- Douglass Hanly Moir Pathology, North Ryde, New South Wales, Australia
| | - Daniel D Wong
- PathWest Laboratory Medical WA, Nedlands, Western Australia, Australia
| | - Anthony J Gill
- The University of Sydney, Sydney, New South Wales, Australia
- Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Alison L Cheah
- Douglass Hanly Moir Pathology, North Ryde, New South Wales, Australia
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3
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Mezzacappa FM, Smith FK, Zhang W, Gard A, Cabuk FK, Gonzalez-Gomez I, Monforte HL, Liang J, Singh O, Quezado MM, Aldape KD, Gokden M, Bridge JA, Chen J. Potential prognostic determinants for FET::CREB fusion-positive intracranial mesenchymal tumor. Acta Neuropathol Commun 2024; 12:17. [PMID: 38291529 PMCID: PMC10826246 DOI: 10.1186/s40478-024-01721-2] [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: 10/27/2023] [Accepted: 12/24/2023] [Indexed: 02/01/2024] Open
Abstract
Intracranial mesenchymal tumor (IMT), FET::CREB fusion-positive is a provisional tumor type in the 2021 WHO classification of central nervous system tumors with limited information available. Herein, we describe five new IMT cases from four females and one male with three harboring an EWSR1::CREM fusion and two featuring an EWSR1::ATF1 fusion. Uniform manifold approximation and projection of DNA methylation array data placed two cases to the methylation class "IMT, subclass B", one to "meningioma-benign" and one to "meningioma-intermediate". A literature review identified 74 cases of IMTs (current five cases included) with a median age of 23 years (range 4-79 years) and a slight female predominance (female/male ratio = 1.55). Among the confirmed fusions, 25 (33.8%) featured an EWSR1::ATF1 fusion, 24 (32.4%) EWSR1::CREB1, 23 (31.1%) EWSR1::CREM, one (1.4%) FUS::CREM, and one (1.4%) EWSR1::CREB3L3. Among 66 patients with follow-up information available (median: 17 months; range: 1-158 months), 26 (39.4%) experienced progression/recurrences (median 10.5 months; range 0-120 months). Ultimately, three patients died of disease, all of whom underwent a subtotal resection for an EWSR1::ATF1 fusion-positive tumor. Outcome analysis revealed subtotal resection as an independent factor associated with a significantly shorter progression free survival (PFS; median: 12 months) compared with gross total resection (median: 60 months; p < 0.001). A younger age (< 14 years) was associated with a shorter PFS (median: 9 months) compared with an older age (median: 49 months; p < 0.05). Infratentorial location was associated with a shorter overall survival compared with supratentorial (p < 0.05). In addition, the EWSR1::ATF1 fusion appeared to be associated with a shorter overall survival compared with the other fusions (p < 0.05). In conclusion, IMT is a locally aggressive tumor with a high recurrence rate. Potential risk factors include subtotal resection, younger age, infratentorial location, and possibly EWSR1::ATF1 fusion. Larger case series are needed to better define prognostic determinants in these tumors.
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Affiliation(s)
- Frank M Mezzacappa
- Department of Neurological Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Frankie K Smith
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Pathology, University of Utah and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Weiwei Zhang
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Andrew Gard
- Department of Neurological Surgery, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Neurological Surgery, MD West ONE, Omaha, NE, USA
| | - Fatmagul Kusku Cabuk
- Department of Pathology, Basaksehir Cam and Sakura City Hospital, Başakşehir, Turkey
| | | | - Hector L Monforte
- Division of Pathology, Johns Hopkins All Children's Hospital, Petersburg, FL, USA
| | - Jiancong Liang
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Omkar Singh
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Martha M Quezado
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth D Aldape
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Murat Gokden
- Department of Pathology, University of Arkansas Medical Center, Little Rock, AR, USA
| | - Julia A Bridge
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Molecular Pathology, ProPath, Dallas, TX, USA
| | - Jie Chen
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA.
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4
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d'Amati A, Gianno F, Scuccimarri L, Lastilla M, Messina R, Signorelli F, Zimatore DS, Barresi S, Miele E, Alaggio R, Rossi S, Maiorano E, Ingravallo G, Giangaspero F, Antonelli M. Intracranial mesenchymal tumor with (novel) COX14::PTEN rearrangement. Acta Neuropathol Commun 2023; 11:95. [PMID: 37312212 DOI: 10.1186/s40478-023-01596-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/30/2023] [Indexed: 06/15/2023] Open
Abstract
Mesenchymal tumors of the central nervous system (CNS) include numerous entities, with different pathological features and biological behavior. Mesenchymal non-meningothelial tumors are rare and comprise neoplasms that are exclusive to the CNS or show peculiar features when occurring in the CNS compared with other sites. Within this group there are three new entities, classified on the basis of specific molecular alterations and included in the 5th edition of the WHO Classification of CNS Tumors: primary intracranial sarcoma; DICER1-mutant; CIC-rearranged sarcoma; intracranial mesenchymal tumor, FET::CREB fusion-positive. These tumors often show variable morphology, making diagnosis very challenging, although the implementation of molecular techniques has led to better characterization and more precise identification of these entities. However, many molecular alterations have yet to be discovered and some recently reported CNS tumors are currently missing an appropriate classification. Herein, we report the case of a 43-year-old man who presented with an intracranial mesenchymal tumor. Histopathological examination showed a wide spectrum of peculiar morphological features and a non-specific immunohistochemical profile. Whole transcriptome sequencing revealed the presence of a novel genetic rearrangement involving COX14 and PTEN genes, which has never been reported before in any other neoplasm. The tumor did not cluster in any defined methylation class of the brain tumor classifier, but resulted in a calibrated score of 0.89 for the methylation class "Sarcoma, MPNST-like", when analyzed by the sarcoma classifier. Our study is the first to report about this tumor with unique pathological and molecular features, characterized by a novel rearrangement between COX14 and PTEN genes. Other studies are necessary in order to define it as a new entity or as a novel rearrangement involving recently described and incompletely characterized CNS mesenchymal tumors.
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Affiliation(s)
- Antonio d'Amati
- Unit of Anatomical Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy.
- Unit of Human Anatomy and Histology, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy.
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Viale Regina Elena 324, Rome, 00161, Italy.
| | - Francesca Gianno
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Viale Regina Elena 324, Rome, 00161, Italy
| | - Luciana Scuccimarri
- Unit of Anatomical Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Michele Lastilla
- Division of Neurosurgery, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Raffaella Messina
- Division of Neurosurgery, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Francesco Signorelli
- Division of Neurosurgery, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Domenico Sergio Zimatore
- Interventional and Diagnostic Neuroradiology Unit, University Hospital Policlinico of Bari, Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Sabina Barresi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Evelina Miele
- Department of Pediatric Onco-Hematology and Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Rita Alaggio
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Sabrina Rossi
- Pathology Unit, Department of Laboratories, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant'Onofrio 4, Rome, 00165, Italy
| | - Eugenio Maiorano
- Unit of Anatomical Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Giuseppe Ingravallo
- Unit of Anatomical Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy
| | - Felice Giangaspero
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Viale Regina Elena 324, Rome, 00161, Italy
| | - Manila Antonelli
- Unit of Anatomical Pathology, Department of Radiology, Oncology and Anatomical Pathology, University La Sapienza, Viale Regina Elena 324, Rome, 00161, Italy
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5
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Pizzimenti C, Gianno F, Gessi M. Expanding the spectrum of "mesenchymal" tumors of the central nervous system. Pathologica 2022; 114:455-464. [PMID: 36534424 PMCID: PMC9763981 DOI: 10.32074/1591-951x-826] [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: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 12/23/2022] Open
Abstract
In this review, we summarize the clinical, histopathological, and molecular features of central nervous system (CNS) tumors with BCOR internal tandem duplication, intracranial mesenchymal tumor with FET/CREB fusion, CNS CIC-rearranged sarcomas and primary intracranial sarcoma DICER1-mutant, now included in the 2021 WHO classification of CNS tumors. Possible relationships between tumors occurring in the CNS and their systemic counterparts are discussed.
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Affiliation(s)
- Cristina Pizzimenti
- Department of Biomedical, Dental, Morphological and Functional Imaging Sciences, University of Messina, Italy
| | - Francesca Gianno
- Department of Radiological, Oncological and Pathological sciences, University of Rome “la Sapienza”Rome Italy
| | - Marco Gessi
- Neuropathology Unit, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy,Correspondence Marco Gessi Neuropathology Unit, Div. of Pathology, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore Largo A. Gemelli 8, 00168 Roma, Italy Tel.: +39-06-30154433 E-mail: ;
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6
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Poyuran R, Shah SP, Kesavapisharady K, Chandrasekharan K, Narasimhaiah D. Intracranial mesenchymal tumour with EWSR1 gene rearrangement: the first report of intracranial mesenchymal tumour with FET-CREB fusion from India. Pathology 2022; 54:945-948. [PMID: 35570029 DOI: 10.1016/j.pathol.2022.02.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 01/31/2022] [Accepted: 02/07/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Rajalakshmi Poyuran
- Departments of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | | | - Krishnakumar Kesavapisharady
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Kesavadas Chandrasekharan
- Department of Imaging Sciences and Intervention Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Deepti Narasimhaiah
- Departments of Pathology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India.
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7
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Hojo K, Furuta T, Komaki S, Yoshikane Y, Kikuchi J, Nakamura H, Ide M, Shima S, Hiyoshi Y, Araki J, Tanaka S, Ozono S, Yoshida A, Nobusawa S, Morioka M, Nishikomori R. Systemic inflammation caused by an intracranial mesenchymal tumor with a
EWSR1
::
CREM
fusion presenting associated with
IL
‐6/
STAT3
signaling. Neuropathology 2022. [DOI: 10.1111/neup.12877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Keishiro Hojo
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Takuya Furuta
- Department of Pathology Kurume University School of Medicine Kurume Japan
| | - Satoru Komaki
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Yukako Yoshikane
- Department of Pediatrics Fukuoka University Chikushi Hospital Chikushino Japan
| | - Jin Kikuchi
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Hideo Nakamura
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Mizuki Ide
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Saho Shima
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Yusuke Hiyoshi
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Junichiro Araki
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Seiji Tanaka
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Shuichi Ozono
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Akihiko Yoshida
- Rare Cancer Center National Cancer Center Hospital Tokyo Japan
- Department of Diagnostic Pathology National Cancer Center Hospital Tokyo Japan
| | - Sumihito Nobusawa
- Department of Human Pathology Gunma University Graduate School of Medicine Maebashi Japan
| | - Motohiro Morioka
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
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8
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Angiomatoid fibrous histiocytoma: an atypical brain location newly described as intracranial mesenchymal tumor FET-CREB fusion-positive. Acta Neurol Belg 2022; 123:691-694. [PMID: 35523929 DOI: 10.1007/s13760-022-01966-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/25/2022] [Indexed: 11/01/2022]
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9
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Sloan EA, Gupta R, Koelsche C, Chiang J, Villanueva-Meyer JE, Alexandrescu S, Eschbacher JM, Wang W, Mafra M, Ud Din N, Carr-Boyd E, Watson M, Punsoni M, Oviedo A, Gilani A, Kleinschmidt-DeMasters BK, Coss DJ, Lopes MB, Reddy A, Mueller S, Cho SJ, Horvai AE, Lee JC, Pekmezci M, Tihan T, Bollen AW, Rodriguez FJ, Ellison DW, Perry A, von Deimling A, Chang SM, Berger MS, Solomon DA. Intracranial mesenchymal tumors with FET-CREB fusion are composed of at least two epigenetic subgroups distinct from meningioma and extracranial sarcomas. Brain Pathol 2021; 32:e13037. [PMID: 34821426 PMCID: PMC9245938 DOI: 10.1111/bpa.13037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/22/2021] [Accepted: 11/05/2021] [Indexed: 01/01/2023] Open
Abstract
‘Intracranial mesenchymal tumor, FET‐CREB fusion‐positive’ occurs primarily in children and young adults and has previously been termed intracranial angiomatoid fibrous histiocytoma (AFH) or intracranial myxoid mesenchymal tumor (IMMT). Here we performed genome‐wide DNA methylation array profiling of 20 primary intracranial mesenchymal tumors with FET‐CREB fusion to further study their ontology. These tumors resolved into two distinct epigenetic subgroups that were both divergent from all other analyzed intracranial neoplasms and soft tissue sarcomas, including meningioma, clear cell sarcoma of soft tissue (CCS), and AFH of extracranial soft tissue. The first subgroup (Group A, 16 tumors) clustered nearest to but independent of solitary fibrous tumor and AFH of extracranial soft tissue, whereas the second epigenetic subgroup (Group B, 4 tumors) clustered nearest to but independent of CCS and also lacked expression of melanocytic markers (HMB45, Melan A, or MITF) characteristic of CCS. Group A tumors most often occurred in adolescence or early adulthood, arose throughout the neuroaxis, and contained mostly EWSR1‐ATF1 and EWSR1‐CREB1 fusions. Group B tumors arose most often in early childhood, were located along the cerebral convexities or spinal cord, and demonstrated an enrichment for tumors with CREM as the fusion partner (either EWSR1‐CREM or FUS‐CREM). Group A tumors more often demonstrated stellate/spindle cell morphology and hemangioma‐like vasculature, whereas Group B tumors more often demonstrated round cell or epithelioid/rhabdoid morphology without hemangioma‐like vasculature, although robust comparison of these clinical and histologic features requires future study. Patients with Group B tumors had inferior progression‐free survival relative to Group A tumors (median 4.5 vs. 49 months, p = 0.001). Together, these findings confirm that intracranial AFH‐like neoplasms and IMMT represent histologic variants of a single tumor type (‘intracranial mesenchymal tumor, FET‐CREB fusion‐positive’) that is distinct from meningioma and extracranial sarcomas. Additionally, epigenomic evaluation may provide important prognostic subtyping for this unique tumor entity.
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Affiliation(s)
- Emily A Sloan
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA.,Department of Pathology and Laboratory Medicine, MedStar Georgetown University Hospital, Washington, D.C., USA
| | - Rohit Gupta
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Christian Koelsche
- Institute of Pathology, Heidelberg University Hospital, Heidelberg, Germany
| | - Jason Chiang
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Javier E Villanueva-Meyer
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California, USA
| | - Sanda Alexandrescu
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer M Eschbacher
- Department of Neuropathology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, Arizona, USA
| | - Wesley Wang
- Department of Pathology, The Ohio State University, Columbus, Ohio, USA
| | - Manuela Mafra
- Department of Pathology, The Portuguese Institute of Oncology, Lisbon, Portugal
| | - Nasir Ud Din
- Section of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan
| | - Emily Carr-Boyd
- Department of Histopathology, ADHB LabPlus, Auckland, New Zealand
| | - Michael Watson
- Department of Histopathology, ADHB LabPlus, Auckland, New Zealand
| | - Michael Punsoni
- Department of Pathology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Angelica Oviedo
- Department of Anatomic Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ahmed Gilani
- Department of Pathology, University of Colorado, Aurora, Colorado, USA
| | | | - Dylan J Coss
- Department of Pathology, Neuropathology Division, University of Virginia Health System, Charlottesville, Virginia, USA
| | - M Beatriz Lopes
- Department of Pathology, Neuropathology Division, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Alyssa Reddy
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.,Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Sabine Mueller
- Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.,Department of Neurology, University of California, San Francisco, San Francisco, California, USA.,Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Soo-Jin Cho
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Andrew E Horvai
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Julieann C Lee
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Melike Pekmezci
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Tarik Tihan
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Andrew W Bollen
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
| | - Fausto J Rodriguez
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David W Ellison
- Department of Pathology, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Arie Perry
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA.,Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Andreas von Deimling
- Department of Neuropathology, Heidelberg University Hospital, Heidelberg, Germany.,German Cancer Research Center (DKFZ), German Consortium for Translational Cancer Research (DKTK), Heidelberg, Germany
| | - Susan M Chang
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA
| | - David A Solomon
- Department of Pathology, University of California, San Francisco, San Francisco, California, USA
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10
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Tauziède-Espariat A, Pierron G, Guillemot D, Sievers P, Cazals-Hatem D, Faillot T, Roux A, Benzakoun J, Bockel S, Weinbreck N, Hasty L, Lechapt E, Chrétien F, Varlet P. A novel SMARCA2-CREM fusion: expanding the molecular spectrum of intracranial mesenchymal tumors beyond the FET genes. Acta Neuropathol Commun 2021; 9:174. [PMID: 34715942 PMCID: PMC8555238 DOI: 10.1186/s40478-021-01278-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/19/2021] [Indexed: 01/12/2023] Open
Abstract
A novel histomolecular tumor of the central nervous system, the “intracranial mesenchymal tumor (IMT), FET-CREB fusion-positive” has recently been identified in the literature and will be added to the 2021 World Health Organization Classification of Tumors of the Central Nervous System. However, our latest study using DNA-methylation analyses has revealed that intracranial FET-CREB fused tumors do not represent a single molecular tumor entity. Among them, the main subgroup presented classical features of angiomatoid fibrous histiocytoma, having ultrastructural features of arachnoidal cells, for. Another tumor type with clear cell component and histopathological signs of aggressivity clustered in close vicinity with clear cell sarcoma of soft tissue. Herein, we report one case of IMT with a novel SMARCA2-CREM fusion which has until now never been described in soft tissue or the central nervous system. We compare its clinical, histopathological, immunophenotypic, genetic and epigenetic features with those previously described in IMT, FET-CREB fusion-positive. Interestingly, the current case did not cluster with IMT, FET-CREB fusion-positive but rather presented histopathological (clear cell morphology with signs of malignancy), clinical (with a dismal course with several recurrences, metastases and finally the patient’s death), genetic (fusion implicating the CREM gene), and epigenetic (DNA-methylation profiling) similarities with our previously reported clear cell sarcoma-like tumor of the central nervous system. Our results added data suggesting that different clinical and histomolecular tumor subtypes or grades seem to be included within the terminology “IMT, FET-CREB fusion-positive”, and that further series of cases are needed to better characterize them.
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