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Suster DI, Gross JM, Fayad L, Wenokor C, Goldsmith JD, Ward A, Early C, Lazano-Calderon S, Klein MJ. Sclerosing epithelioid fibrosarcoma of bone with hybrid features: clinicopathologic, radiologic, and molecular analysis of three cases. Skeletal Radiol 2024; 53:387-393. [PMID: 37524934 DOI: 10.1007/s00256-023-04412-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/13/2023] [Accepted: 07/24/2023] [Indexed: 08/02/2023]
Abstract
Sclerosing epithelioid fibrosarcoma (SEF) occurring as a primary bone tumor is exceptionally uncommon. Even more rare are cases of SEF that show morphologic overlap with low-grade fibromyxoid sarcoma (LGFMS). Such hybrid lesions arising within the bone have only rarely been reported in the literature. Due to their variegated histomorphology and non-specific radiologic features, these tumors may pose diagnostic difficulties. Herein we describe three molecularly confirmed primary bone cases of sclerosing epithelioid fibrosarcoma that demonstrated prominent areas showing the features of LGFMS and with areas resembling so-called hyalinizing spindle cell tumor with giant rosettes (HSCTGR). Two patients were female and one was male aged 26, 47, and 16, respectively. The tumors occurred in the femoral head, clavicle, and temporal bone. Imaging studies demonstrated relatively well-circumscribed radiolucent bone lesions with enhancement on MRI. Cortical breakthrough and soft tissue extension were present in one case. Histologically the tumors all demonstrated hyalinized areas with SEF-like morphology as well as spindled and myxoid areas with LGFMS-like morphology. Two cases demonstrated focal areas with rosette-like architecture as seen in HSCTGR. The tumors were all positive for MUC4 by immunohistochemistry and cytogenetics, fluorescence in-situ hybridization, and next-generation sequencing studies identified EWSR1 gene rearrangements confirming the diagnosis in all three cases.Hybrid SEF is exceedingly rare as a primary bone tumor and can be difficult to distinguish from other low-grade spindled and epithelioid lesions of bone. MUC4 positivity and identification of underlying EWSR1 gene rearrangements help support this diagnosis and exclude other tumor types.
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Affiliation(s)
- David I Suster
- Department of Pathology, Rutgers University New Jersey Medical School, 150 Bergen Street, Newark, NJ, 07103, USA.
| | - John M Gross
- Department of Pathology, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura Fayad
- Department of Radiology, Orthopaedic Surgery and Oncology, John Hopkins University School of Medicine, Baltimore, MD, USA
| | - Cornelia Wenokor
- Department of Radiology, Rutgers University New Jersey Medical School, Newark, NJ, USA
| | - Jeffrey D Goldsmith
- Department of Pathology, Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA, USA
| | - Ashley Ward
- Department of Pathology, Beth Israel Deaconess Medical Center Harvard Medical School, Boston, MA, USA
| | - Caroline Early
- Department of Pathology, John Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Michael J Klein
- Department of Pathology, Hospital for Special Surgery, New York, NY, USA
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Dewaele B, Libbrecht L, Levy G, Brichard B, Vanspauwen V, Sciot R, Debiec-Rychter M. A novelEWS-CREB3L3gene fusion in a mesenteric sclerosing epithelioid fibrosarcoma. Genes Chromosomes Cancer 2017; 56:695-699. [DOI: 10.1002/gcc.22474] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/24/2017] [Accepted: 05/25/2017] [Indexed: 01/01/2023] Open
Affiliation(s)
- Barbara Dewaele
- Department of Human Genetics; KU Leuven and University Hospitals Leuven; Leuven Belgium
| | - Louis Libbrecht
- Department of Pathology; Cliniques Universitaires Saint-Luc, Université Catholique de Louvain; Brussels Belgium
| | - Gabriel Levy
- Department of Pediatric Oncology and Hematology; Cliniques Universitaires Saint-Luc, Université Catholique de Louvain; Brussels Belgium
| | - Benedicte Brichard
- Department of Pediatric Oncology and Hematology; Cliniques Universitaires Saint-Luc, Université Catholique de Louvain; Brussels Belgium
| | - Vanessa Vanspauwen
- Department of Human Genetics; KU Leuven and University Hospitals Leuven; Leuven Belgium
| | - Raf Sciot
- Department of Human Pathology; KU Leuven and University Hospitals Leuven; Leuven Belgium
| | - Maria Debiec-Rychter
- Department of Human Genetics; KU Leuven and University Hospitals Leuven; Leuven Belgium
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