1
|
Shin E, Kim HM, Koo JS. CD68 positive and/or CD163 positive tumor-associated macrophages and PD-L1 expression in breast phyllodes tumor. Breast Cancer Res Treat 2024:10.1007/s10549-024-07487-4. [PMID: 39242456 DOI: 10.1007/s10549-024-07487-4] [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: 06/12/2024] [Accepted: 08/28/2024] [Indexed: 09/09/2024]
Abstract
INTRODUCTION PD-L1 expression and tumor-associated macrophage (TAM) status in phyllodes tumors (PT) have only been examined in a limited number of studies. This study aimed to investigate the expression of PD-L1 and TAM in breast PT and examine their implications. METHODS Tissue microarrays were constructed from 181 PT samples, and immunohistochemistry for PD-L1 antibodies (SP142, SP263, and 22C3) and TAM markers (CD68 and CD163) were performed. The staining results were compared and analyzed with clinicopathological parameters. RESULTS Of the 181 samples, 149 were benign, 27 were borderline, and five were malignant. The number of CD68- and/or CD163-positive TAMs increased with increasing PT grades (P < 0.001), and the number of CD68-positive TAMs was significantly positively correlated with that of CD163-positive TAMs (R = 0.704, P < 0.001). Some of the CD68- and/or CD163-positive cells exhibited positivity for actin staining, displaying hybrid characteristics that resemble both histiocytes and myofibroblasts. PD-L1 SP263 tumor cells and PD-L1 SP263 immune cells were the most expressed in malignant PTs (P < 0.001). The number of CD68- and/or CD163-positive TAMs increased when PD-L1 SP263 immune cells were expressed (P < 0.001). The number of CD68- and/or CD163-positive TAMs was positively correlated with PD-L1 22C3 immune cells (R = 0.299, P < 0.001 and R = 0.336, P < 0.001, respectively). Univariate analysis showed that PD-L1 SP263 immune cell expression (P = 0.016) was associated with shorter disease-free survival and that PD-L1 22C3 tumor cell expression (P < 0.001) was associated with shorter overall survival. CONCLUSION The number of CD68- and/or CD163-positive cells increases with increasing PT histological grade, and these cells exhibit hybrid characteristics, resembling both histiocyte and myofibroblasts.
Collapse
Affiliation(s)
- Eunah Shin
- Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Min Kim
- Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea
| | - Ja Seung Koo
- Department of Pathology, Yonsei University College of Medicine, Seoul, South Korea.
| |
Collapse
|
2
|
Kitazono I, Akahane T, Sasaki H, Ohi Y, Shinden Y, Takajo T, Tasaki T, Higashi M, Noguchi H, Hisaoka M, Tanimoto A. Malignant phyllodes tumor with EGFR variant III mutation: A rare case report with immunohistochemical and genomic studies. Pathol Res Pract 2024; 259:155389. [PMID: 38850845 DOI: 10.1016/j.prp.2024.155389] [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: 04/24/2024] [Accepted: 06/01/2024] [Indexed: 06/10/2024]
Abstract
A female in her 60's presented with a left-sided breast mass. A core needle biopsy specimen showed diffuse proliferation of a round cell tumor, which was positive for vimentin, NKX2.2, BCOR, and focal CD99 on immunohistochemistry (IHC). No fusion genes of the Ewing family sarcomas were detected. With a tentative diagnosis of primary breast sarcoma (PBS), total mastectomy was performed after chemotherapy. The resected tissues showed proliferation of round or spindle-shaped tumor cells with a high nuclear-to-cytoplasmic ratio, exhibiting solid and fascicular arrangements but no epithelial component or organoid pattern. While IHC indicated no particular histological diagnosis, genomic examination revealed gene alterations in MED12 p.G44D, MLL2 (KMT2D) p.T1496fs*27, and EGFR variant III (vIII). Moreover, a retrospective IHC study showed overexpression of EGFRvIII. A malignant phyllodes tumor (PT) with extensive sarcomatous overgrowth was indicated as an integrative diagnosis. This is a rare case of a malignant PT harboring EGFRvIII. The present case provides an importance of accurate diagnosis and genomic analysis of rare breast tumors, as malignant PT and PBS are different in its treatment strategy and prognosis.
Collapse
Affiliation(s)
- Ikumi Kitazono
- Department of Surgical Pathology, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Toshiaki Akahane
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Hiromi Sasaki
- Department of Orthopedic Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Yasuyo Ohi
- Department of Pathology, Hakuaikai Sagara Hospital, 3-31 Matsubara-cho, Kagoshima 892-0833, Japan
| | - Yoshiaki Shinden
- Department of Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Tomoko Takajo
- Department of Neurosurgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Takashi Tasaki
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Michiyo Higashi
- Department of Surgical Pathology, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Hirotsugu Noguchi
- Department of Surgical Pathology, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Masanori Hisaoka
- Department of Pathology and Oncology, University of Occupational and Environmental Health, 1-1 Iseigaoka, Kitakyushu 807-8556, Japan
| | - Akihide Tanimoto
- Department of Surgical Pathology, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan; Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
| |
Collapse
|
3
|
Meyer B, Stirzaker C, Ramkomuth S, Harvey K, Chan B, Lee CS, Karim R, Deng N, Avery-Kiejda KA, Scott RJ, Lakhani S, Fox S, Robbins E, Shin JS, Beith J, Gill A, Sioson L, Chan C, Krishnaswamy M, Cooper C, Warrier S, Mak C, Rasko JE, Bailey CG, Swarbrick A, Clark SJ, O'Toole S, Pidsley R. Detailed DNA methylation characterisation of phyllodes tumours identifies a signature of malignancy and distinguishes phyllodes from metaplastic breast carcinoma. J Pathol 2024; 262:480-494. [PMID: 38300122 DOI: 10.1002/path.6250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 11/03/2023] [Accepted: 12/07/2023] [Indexed: 02/02/2024]
Abstract
Phyllodes tumours (PTs) are rare fibroepithelial lesions of the breast that are classified as benign, borderline, or malignant. As little is known about the molecular underpinnings of PTs, current diagnosis relies on histological examination. However, accurate classification is often difficult, particularly for distinguishing borderline from malignant PTs. Furthermore, PTs can be misdiagnosed as other tumour types with shared histological features, such as fibroadenoma and metaplastic breast cancers. As DNA methylation is a recognised hallmark of many cancers, we hypothesised that DNA methylation could provide novel biomarkers for diagnosis and tumour stratification in PTs, whilst also allowing insight into the molecular aetiology of this otherwise understudied tumour. We generated whole-genome methylation data using the Illumina EPIC microarray in a novel PT cohort (n = 33) and curated methylation microarray data from published datasets including PTs and other potentially histopathologically similar tumours (total n = 817 samples). Analyses revealed that PTs have a unique methylome compared to normal breast tissue and to potentially histopathologically similar tumours (metaplastic breast cancer, fibroadenoma and sarcomas), with PT-specific methylation changes enriched in gene sets involved in KRAS signalling and epithelial-mesenchymal transition. Next, we identified 53 differentially methylated regions (DMRs) (false discovery rate < 0.05) that specifically delineated malignant from non-malignant PTs. The top DMR in both discovery and validation cohorts was hypermethylation at the HSD17B8 CpG island promoter. Matched PT single-cell expression data showed that HSD17B8 had minimal expression in fibroblast (putative tumour) cells. Finally, we created a methylation classifier to distinguish PTs from metaplastic breast cancer samples, where we revealed a likely misdiagnosis for two TCGA metaplastic breast cancer samples. In conclusion, DNA methylation alterations are associated with PT histopathology and hold the potential to improve our understanding of PT molecular aetiology, diagnostics, and risk stratification. © 2024 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
Collapse
Affiliation(s)
- Braydon Meyer
- Epigenetics Research Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Clare Stirzaker
- Epigenetics Research Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Sonny Ramkomuth
- Tumour Progression Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Kate Harvey
- Tumour Progression Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Belinda Chan
- Department of Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Cheok Soon Lee
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Department of Anatomical Pathology and Molecular Pathology Laboratory, Liverpool Hospital, Liverpool, New South Wales, Australia
- Discipline of Pathology, School of Medicine, Western Sydney University, Liverpool, New South Wales, Australia
| | - Rooshdiya Karim
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Niantao Deng
- Tumour Progression Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Kelly A Avery-Kiejda
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, New South Wales, Australia
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
| | - Rodney J Scott
- Discipline of Medical Genetics, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Sunil Lakhani
- UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia
- Pathology Queensland, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Stephen Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Elizabeth Robbins
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Joo-Shik Shin
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
| | - Jane Beith
- Psycho-Oncology Co-Operative Group (PoCoG), University of Sydney, Sydney, New South Wales, Australia
- Chris O'Brien Lifehouse, Sydney, New South Wales, Australia
- University of Sydney, Sydney, New South Wales, Australia
| | - Anthony Gill
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Sydney Medical School, University of Sydney, St Leonards, New South Wales, Australia
| | - Loretta Sioson
- Cancer Diagnosis and Pathology Group, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- NSW Health Pathology, Department of Anatomical Pathology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
- Sydney Medical School, University of Sydney, St Leonards, New South Wales, Australia
| | - Charles Chan
- NSW Health Pathology, Department of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Mrudula Krishnaswamy
- NSW Health Pathology, Department of Anatomical Pathology, Concord Repatriation General Hospital, Sydney, New South Wales, Australia
- Concord Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Caroline Cooper
- Anatomical Pathology, Pathology Queensland, Princess Alexandra Hospital, Woolloongabba, Queensland, Australia
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
| | - Sanjay Warrier
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Sydney Medical Program, The University of Sydney, Sydney, New South Wales, Australia
- Department of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - Cindy Mak
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
- Department of Breast Surgery, Chris O'Brien Lifehouse, Camperdown, New South Wales, Australia
| | - John Ej Rasko
- Faculty of Medicine, The University of Queensland, St Lucia, Queensland, Australia
- Department of Cell and Molecular Therapies, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, Sydney, New South Wales, Australia
| | - Charles G Bailey
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Gene and Stem Cell Therapy Program, Centenary Institute, Sydney, New South Wales, Australia
- Cancer and Gene Regulation Laboratory Centenary Institute, The University of Sydney, Camperdown, New South Wales, Australia
| | - Alexander Swarbrick
- St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
- Tumour Progression Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
| | - Susan J Clark
- Epigenetics Research Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Sandra O'Toole
- Tumour Progression Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- Department of Tissue Pathology and Diagnostic Oncology, NSW Health Pathology, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Ruth Pidsley
- Epigenetics Research Laboratory, Cancer Ecosystems Program, Garvan Institute of Medical Research, Sydney, New South Wales, Australia
- St. Vincent's Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
4
|
Zheng L, Luthra R, Alvarez HA, San Lucas FA, Duose DY, Wistuba II, Fuller GN, Ballester LY, Roy-Chowdhuri S, Sweeney KJ, Rashid A, Yang RK, Chen W, Liu A, Wu Y, Albarracin C, Patel KP, Routbort MJ, Sahin AA, Ding Q, Chen H. Intragenic EGFR::EGFR.E1E8 Fusion (EGFRvIII) in 4331 Solid Tumors. Cancers (Basel) 2023; 16:6. [PMID: 38201434 PMCID: PMC10778229 DOI: 10.3390/cancers16010006] [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: 10/07/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024] Open
Abstract
Epidermal growth factor receptor variant III (EGFRvIII, the deletion of exons 2-7) is a recurrent intragenic EGFR::EGFR.E1E8 fusion that occurs in high-grade gliomas. The presence of EGFRvIII in other solid tumors has not been well characterized. We retrospectively reviewed advanced malignant solid tumor cases tested by a custom hybrid capture 610-gene next-generation sequencing platform from 2021 to 2022. EGFRvIII was identified in 17 of 4331 (0.4%) cases, including 16 of 238 (7%) brain tumors and 1/301 (0.3%) breast tumors. EGFRvIII-positive brain tumors were all glioblastoma IDH-wildtype, most with concurrent TERT promoter mutation (14 of 16), EGFR amplification (13 of 16), and EGFR mutation (8 of 16). The only EGFRvIII-positive breast lesion was a sarcomatoid neoplasm in a young female patient. A separate breast case tested outside our institution with reported EGFRvIII was noted in a young female patient with a malignant phyllodes tumor with stromal overgrowth. Microscopically, both EGFRvIII-positive breast tumors showed high-grade sarcomatoid morphology with brisk mitotic activity. In summary, EGFRvIII is rare, occurring primarily in glioblastoma and rarely in breast sarcomatoid neoplasm, with no instances identified in other tumor types in our series. This select group of patients may benefit from chemotherapy and/or targeted anti-EGFR therapy.
Collapse
Affiliation(s)
- Lan Zheng
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Rajyalakshmi Luthra
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (H.A.A.)
| | - Hector A. Alvarez
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (H.A.A.)
| | - F. Anthony San Lucas
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (H.A.A.)
| | - Dzifa Y. Duose
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (I.I.W.)
| | - Ignacio I. Wistuba
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (I.I.W.)
| | - Gregory N. Fuller
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Leomar Y. Ballester
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Sinchita Roy-Chowdhuri
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Keith J. Sweeney
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Asif Rashid
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Richard K. Yang
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Wei Chen
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (H.A.A.)
| | - Audrey Liu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Yun Wu
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Constance Albarracin
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Keyur P. Patel
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (H.A.A.)
| | - Mark J. Routbort
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (H.A.A.)
| | - Aysegul A. Sahin
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Qingqing Ding
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| | - Hui Chen
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Y.W.); (C.A.); (A.A.S.)
| |
Collapse
|
5
|
Belhadj A, Brikci SB, Akhrouf C, Belhadj A, Medjamia M, Sahraoui T. Co expression of EGFR and CD10 in patients with phyllodes tumors of the breast: a single center experience in North Western Algeria. Afr Health Sci 2023; 23:266-274. [PMID: 38974258 PMCID: PMC11225475 DOI: 10.4314/ahs.v23i4.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2024] Open
Abstract
Background Breast phyllodes tumors (BPT) have variable malignant potential, their histological classification remains insufficient for an accurate diagnosis. Objectives We attempted to investigate CD10 (Cluster of differentiation 10) and EGFR (Epidermal growth factor receptor) expression in BPT in order to highlight their diagnostic and prognostic values. Methods Eight patients with BPT are recruited from January 2014 to December 2020 and immunohistochemical assessment of CD10 and EGFR is realized. Results Median age was 27±15.2, the mean tumor size was 9.63±10.21. Only malignant tumours showed expression for EGFR. Borderline and malignant tumors were CD10 positive. Patients overexpressing CD10 were postmenopausal with great tumor size, 25% of these were sarcomatous. Coexistence of CD10 and EGFR overexpression was found in 25% of cases and was associated with age (P=0.008), tumor size (P=0.030) and hitologic types (P=0.014). PC1 and PC2, were extracted, they accounted cumulatively for 94.7% of the variance of the data analysed, it suggests that patient's age and histological type of tumor have significant association with CD10 and EGFR expression in BPT. Conclusions EGFR and CD10 overexpressed combined proteins in phyllode tumors constitute, with histopathological parameters, an important prognostic factor as well as a promising potential targets.
Collapse
Affiliation(s)
- Amina Belhadj
- Biology of Development and Differentiation Laboratory, Oran 1 University, Ahmed Ben Bella, Department of Biology, Faculty of Nature and Life sciences
| | - Samia Bekkal Brikci
- Biology of Development and Differentiation Laboratory, Oran 1 University, Ahmed Ben Bella, Department of Biology, Faculty of Nature and Life sciences
| | - Chahinez Akhrouf
- Biology of Development and Differentiation Laboratory, Oran 1 University, Ahmed Ben Bella, Department of Biology, Faculty of Nature and Life sciences
| | - Adel Belhadj
- Faculty of Medicine, University of Oran 1, Ahmed Ben Bella Algeria
| | - Miloud Medjamia
- Anatomy pathology laboratory. Military hospital. Oran. Algeria
| | - Tewfik Sahraoui
- Biology of Development and Differentiation Laboratory, Oran 1 University, Ahmed Ben Bella, Department of Biology, Faculty of Nature and Life sciences
| |
Collapse
|
6
|
Yun J, Heo W, Lee ES, Na D, Kang W, Kang J, Chae J, Lee D, Lee W, Hwang J, Yoo TK, Hong BS, Son HY, Noh DY, Lee C, Moon HG, Kim JI. An integrative approach for exploring the nature of fibroepithelial neoplasms. Br J Cancer 2023; 128:626-637. [PMID: 36522480 PMCID: PMC9938154 DOI: 10.1038/s41416-022-02064-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 11/09/2022] [Accepted: 11/10/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Malignant phyllodes tumour (MPT) is a rare breast malignancy with epithelial and mesenchymal features. Currently, there are no appropriate research models or effective targeted therapeutic approaches for MPT. METHODS We collected fresh frozen tissues from nine patients with MPT and performed whole-exome and RNA sequencing. Additionally, we established patient-derived xenograft (PDX) models from patients with MPT and tested the efficacy of targeting dysregulated pathways in MPT using the PDX model from one MPT. RESULTS MPT has unique molecular characteristics when compared to breast cancers of epithelial origin and can be classified into two groups. The PDX model derived from one patient with MPT showed that the mouse epithelial component increased during tumour growth. Moreover, targeted inhibition of platelet-derived growth factor receptor (PDGFR) and phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) by imatinib mesylate and PKI-587 showed in vivo tumour suppression effects. CONCLUSIONS This study revealed the molecular profiles of MPT that can lead to molecular classification and potential targeted therapy, and suggested that the MPT PDX model can be a useful tool for studying the pathogenesis of fibroepithelial neoplasms and for preclinical drug screening to find new therapeutic strategies for MPT.
Collapse
Affiliation(s)
- Jihui Yun
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woohang Heo
- Interdisciplinary Program on Tumor Biology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun-Shin Lee
- Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Deukchae Na
- Ewha Institute of Convergence Medicine, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea
| | - Wonyoung Kang
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
- Department of Life Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Jinjoo Kang
- Department of Life Sciences, Ewha Womans University, Seoul, Republic of Korea
| | - Jeesoo Chae
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dakyung Lee
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Woochan Lee
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jinha Hwang
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Tae-Kyung Yoo
- Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea
| | - Bok Sil Hong
- Center for Medical Innovation, Seoul National University Hospital, Seoul, Republic of Korea
| | - Hye-Youn Son
- Center for Medical Innovation, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dong-Young Noh
- Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Charles Lee
- The Jackson Laboratory for Genomic Medicine, Farmington, Connecticut, USA
- Department of Life Sciences, Ewha Womans University, Seoul, Republic of Korea
- Precision Medicine Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, People's Republic of China
| | - Hyeong-Gon Moon
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea.
- Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea.
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
- Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea.
| | - Jong-Il Kim
- Genomic Medicine Institute, Medical Research Center, Seoul National University, Seoul, Republic of Korea.
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
- Department of Biochemistry and Molecular Biology, Seoul National University College of Medicine, Seoul, Republic of Korea.
| |
Collapse
|
7
|
Lei T, Shen M, Deng X, Shi Y, Peng Y, Wang H, Chen T. Genomic characteristics of two breast malignant phyllodes tumors during pregnancy and lactation identified through whole-exome sequencing. Orphanet J Rare Dis 2022; 17:382. [PMID: 36271373 PMCID: PMC9587670 DOI: 10.1186/s13023-022-02537-w] [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: 04/26/2022] [Revised: 09/19/2022] [Accepted: 10/04/2022] [Indexed: 11/29/2022] Open
Abstract
Background The genomic landscape of breast malignant phyllodes tumors (PTs) is not well defined, especially pregnancy-related malignant PTs. To clarify this topic, whole-exome next-generation sequencing (NGS) was performed on tumor samples and paired normal breast tissues from two pregnancy-related malignant PTs, followed by a functional analysis of the genetic alterations. Methods DNA from malignant PT samples and matched normal breast tissues of both patients were subjected to molecular profiling. NGS of the whole-exome was performed in a commercial molecular pathology laboratory. Predictive tools were used to estimate genetic variation in somatic and germline genes. Results In total, 29 somatic genomic alterations and 18 germline alterations were found in both patients. In Patient 1, 12 aberrations were identified in the tumor tissue, and 9 alterations were identified in matched normal breast tissue. One pathogenic variant in tumor suppressor genes (TP53) was detected in patient 1. In Patient 2, 18 and 10 variants were found in the tumor and matched normal breast tissue, respectively. In Patient 2, pathogenic alterations were identified in two tumor suppressor genes (PTEN and TP53). PTEN and TP53 may be potential drug targets. The functional predictive tools showed that genes of unknown significance for PTs, including FCHO1 in Patient 1, and LRP12 and PKM in Patient 2, were pathogenic. Several genes, including FCHO1, LRP12 and PKM, were shown for the first time to be altered in malignant PTs. A potentially pathogenic germline variant in PRF1, was detected in Patient 1. Conclusion Our study first demonstrated somatic and germline gene alterations in two malignant PTs during pregnancy and lactation. These two PTs shared major genetic events, including TP53 mutation, which commonly occurs in malignant PTs; additionally, we identified two potential genes for targeted therapy, TP53 and PTEN. One germline mutation in PRF1 was also detected. These results provide clues regarding tumor pathogenesis and precision therapy development. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02537-w.
Collapse
Affiliation(s)
- Tinge Lei
- Department of Pathology, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, Jiangsu, P.R. China
| | - Mengjia Shen
- Department of Pathology, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, 610041, Chengdu, Sichuan, China
| | - Xu Deng
- Department of Pathology, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, Jiangsu, P.R. China
| | - Yongqiang Shi
- Department of Pathology, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, Jiangsu, P.R. China
| | - Yan Peng
- Department of Pathology, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, Jiangsu, P.R. China
| | - Hui Wang
- Department of Pathology, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, Jiangsu, P.R. China
| | - Tongbing Chen
- Department of Pathology, The Third Affiliated Hospital of Soochow University, 213003, Changzhou, Jiangsu, P.R. China.
| |
Collapse
|
8
|
Lerwill MF, Lee AHS, Tan PH. Fibroepithelial tumours of the breast-a review. Virchows Arch 2021; 480:45-63. [PMID: 34505197 DOI: 10.1007/s00428-021-03175-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/08/2021] [Accepted: 07/25/2021] [Indexed: 12/24/2022]
Abstract
Fibroepithelial tumours of the breast are biphasic neoplasms composed of both epithelial and stromal elements, including the common fibroadenoma and the infrequent phyllodes tumour. The admixture of epithelium and stroma in the fibroadenoma shows intra- and pericanalicular patterns, and may display a variety of histological changes. Fibroadenoma variants include the cellular, juvenile, myxoid and complex forms. The cellular fibroadenoma may be difficult to distinguish from the benign phyllodes tumour. Stromal mitotic activity can be increased in fibroadenomas in the young and pregnant patients. Phyllodes tumours, neoplasms with the potential for recurrence, show an exaggerated intracanalicular growth pattern with broad stromal fronded architecture and stromal hypercellularity. They are graded into benign, borderline and malignant forms based on histological assessment of stromal features of hypercellularity, atypia, mitotic activity, overgrowth and the nature of the tumour borders. Classification of phyllodes tumours is imperfect, compounded by tumour heterogeneity with overlapping microscopic features among the different grades, especially in the borderline category. Malignant phyllodes tumours can metastasise and cause death. Determining which phyllodes tumours may behave aggressively has been difficult. The discovery of MED12 mutations in the pathogenesis of fibroepithelial tumours, together with other gene abnormalities in the progression pathway, has allowed refinements in diagnosis and prognosis.
Collapse
Affiliation(s)
- Melinda F Lerwill
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew H S Lee
- Department of Histopathology, Nottingham University Hospitals, Nottingham, UK
| | - Puay Hoon Tan
- Division of Pathology, Singapore General Hospital, Singapore, Singapore.
| |
Collapse
|
9
|
Reinisch M, Kuemmel S, Breit E, Theuerkauf I, Harrach H, Schindowski D, Moka D, Bettstetter M, Bruzas S, Chiari O. Two progressed malignant phyllodes tumors of the breast harbor alterations in genes frequently involved in other advanced cancers. Orphanet J Rare Dis 2021; 16:363. [PMID: 34399808 PMCID: PMC8365991 DOI: 10.1186/s13023-021-01986-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 07/27/2021] [Indexed: 12/13/2022] Open
Abstract
Background The genomic landscape of phyllodes tumors (PTs) of the breast is not well defined, especially in patients with advanced disease. To shed light on this topic, paired primary and progressed tumor samples from two patients with malignant PTs were subjected to next-generation sequencing (NGS) followed by functional analysis of genetic alterations using two prediction tools. Methods The DNA of both the primary tumor and distant metastases of Patient 1 and the primary and recurrent tumor of Patient 2 were subjected to molecular profiling. NGS with the FoundationOne® assay was performed in a commercial molecular pathology laboratory. Two in silico prediction tools were used to estimate the pathogenicity of indicated genetic alterations. Results In total, 38 genomic alterations were detected, of which 11 were predicted to be probably benign. In Patient 1, 14 aberrations were identified in the primary tumor and 17 in pulmonary metastases, 12 of which were identical. In the primary and recurrent tumor of Patient 2, 17 and 15 sequence variants, respectively, were found, with 13 overlapping findings. Affected genes included seven (TP53, TERT, APC, ARID1A, EGFR, KMT2D, and RB1) of the top 10 most frequently altered genes in other advanced cancer entities, as well as four actionable therapeutic targets (EGFR, KIT, PDGFRA, and BRIP1). Of note, seven genes coding for receptor tyrosine kinases were affected: three in Patient 1 and four in Patient 2. Several genes (e.g. EPHA3, EPHA7, and EPHB1) were shown to be altered for the first time in PTs. Conclusions The two progressed malignant PTs investigated here share some of the major genetic events occurring in other advanced cancers. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-01986-z.
Collapse
Affiliation(s)
| | - Sherko Kuemmel
- Breast Unit, Kliniken Essen-Mitte, 45136, Essen, Germany.,Department of Gynecology with Breast Center, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt- Universität zu Berlin, 10117, Berlin, Germany
| | | | | | - Hakima Harrach
- Breast Unit, Kliniken Essen-Mitte, 45136, Essen, Germany
| | | | - Detlef Moka
- Nuclear Medicine Centre, 45136, Essen, Germany
| | - Marcus Bettstetter
- Teilgemeinschaftspraxis Molekularpathologie Südbayern, 81539, München, Germany
| | - Simona Bruzas
- Breast Unit, Kliniken Essen-Mitte, 45136, Essen, Germany
| | - Ouafaa Chiari
- Breast Unit, Kliniken Essen-Mitte, 45136, Essen, Germany
| |
Collapse
|
10
|
Conduit C, Luen S, Xu H, Byrne D, Fox S, Desai J, Hamilton A. Using Genomic Sequencing to Explain an Exceptional Response to Therapy in a Malignant Phyllodes Tumor. JCO Precis Oncol 2020; 4:1263-1266. [PMID: 35050785 DOI: 10.1200/po.20.00305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
- Ciara Conduit
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Stephen Luen
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Huiling Xu
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Clinical Pathology, Faculty of Medicine Dentistry and Health Science, University of Melbourne, Parkville, Victoria, Australia
| | - David Byrne
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Stephen Fox
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Cancer Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Clinical Pathology, Faculty of Medicine Dentistry and Health Science, University of Melbourne, Parkville, Victoria, Australia
| | - Jayesh Desai
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, Victoria, Australia
| | - Anne Hamilton
- Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| |
Collapse
|
11
|
Tan BY, Md Nasir ND, Chang HY, Ng CCY, Guan P, Nagarajan S, Rajasegaran V, Lee JY, Lim JQ, Thike AA, Teh BT, Tan PH. Morphologic and genetic heterogeneity in breast fibroepithelial lesions-a comprehensive mapping study. Mod Pathol 2020; 33:1732-1745. [PMID: 32322022 DOI: 10.1038/s41379-020-0533-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 03/18/2020] [Accepted: 03/18/2020] [Indexed: 02/01/2023]
Abstract
Breast fibroepithelial lesions (FELs) encompass the common fibroadenoma (FA) and relatively rare phyllodes tumour (PT); the latter entity is usually classified as benign, borderline or malignant. Intratumoural heterogeneity is frequently present in these tumours, making accurate histologic evaluation challenging. Despite their rarity, PTs are an important clinical problem due to their propensity for recurrence and, in the case of malignant PT, metastasis. Surgical excision is the mainstay of management. Recent work has uncovered myriad genetic alterations in breast FELs. In this study, exome sequencing was performed on seven cases of morphologically heterogeneous breast FELs, including FAs, PTs of all grades, and a case of metaplastic spindle cell carcinoma arising in PT, in order to elucidate their intratumoural genetic repertoire. Gene mutations identified encompassed cell signalling, tumour suppressor, DNA repair and cell cycle regulating pathways. Mutations common to multiple tumour regions generally showed higher variant allele frequency. Frequent mutations included MED12, TP53, RARA and PIK3CA. Histological observations of increased cellular density and pleomorphism correlated with mutational burden. Phylogenetic analyses revealed disparate pathways of possible tumour progression. In summary, histological heterogeneity correlated with genetic changes in breast FELs.
Collapse
Affiliation(s)
| | - Nur Diyana Md Nasir
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore
| | | | - Cedric Chuan Young Ng
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore, Singapore
| | - Peiyong Guan
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore, Singapore.,Quantitative Biology and Medicine Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Sanjanaa Nagarajan
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Jing Yi Lee
- Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore, Singapore
| | - Jing Quan Lim
- Lymphoma Genomic Translational Laboratory, National Cancer Centre Singapore, Singapore, Singapore
| | - Aye Aye Thike
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Bin Tean Teh
- Duke-NUS Medical School, Singapore, Singapore. .,Laboratory of Cancer Epigenome, National Cancer Centre Singapore, Singapore, Singapore.
| | - Puay Hoon Tan
- Department of Anatomical Pathology, Singapore General Hospital, Singapore, Singapore. .,Duke-NUS Medical School, Singapore, Singapore. .,Division of Pathology, Singapore General Hospital, Singapore, Singapore.
| |
Collapse
|
12
|
Neron M, Sajous C, Thezenas S, Piperno-Neumann S, Reyal F, Laé M, Chakiba C, Penel N, Ryckewaert T, Honoré C, Bertucci F, Monneur A, Salas S, Duffaud F, Saada-Bouzid E, Isambert N, Brahmi M, Ray-Coquard I, Blay JY, Firmin N. Impact of Metastasis Surgery and Alkylating-Agent-Based Chemotherapy on Outcomes of Metastatic Malignant Phyllodes Tumors: A Multicenter Retrospective Study. Ann Surg Oncol 2019; 27:1693-1699. [PMID: 31773519 DOI: 10.1245/s10434-019-08097-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Metastatic phyllodes tumors have poor prognosis with median overall survival of 11.5 months. The objective of this study is to identify prognostic factors and the best options for management of metastatic malignant phyllode tumors (MMPTs). PATIENTS AND METHODS A multicentric retrospective study, including cases of MMPT from 10 sarcoma centers, was conducted. The primary end-point was overall survival (OS), and the secondary end-point was the clinical benefit of chemotherapy (CBCT) rate. RESULTS 51 MMPT patients were included. Median time from diagnosis to metastatic recurrence was 13 months. Management of MMPT consisted in surgery of the metastatic disease for 16 patients (31.3%), radiation therapy of the metastatic disease for 15 patients (31.9%), and chemotherapy for 37 patients (72.5%). Median follow-up was 62.1 months [95% confidence interval (CI) 31-80 months]. Median OS was 11.5 months (95% CI 7.5-18.7 months). On multivariate analysis, two or more metastatic sites [hazard ratio (HR) 2.81, 95% CI 1.27-6.19; p = 0.01] and surgery of metastasis (HR 0.33, 95% CI 0.14-0.78; p = 0.01) were independently associated with OS. The CBCT rate was 31.4% and 16.7% for the first and second lines. Polychemotherapy was not superior to single-agent therapy. Alkylating-agent-based chemotherapy, possibly associated with anthracyclines, was associated with a better CBCT rate than anthracyclines alone (p = 0.049). CONCLUSIONS The results of this study emphasize the impact of the number of metastatic sites on survival of MMPT patients and the leading role of metastasis surgery in MMPT management. If systemic therapy is used, it should include alkylating agents, which are associated with a better clinical benefit.
Collapse
Affiliation(s)
- Mathias Neron
- Department of Surgical Oncology, Institut du Cancer Montpellier (ICM), Univ Montpellier, Montpellier, France.
| | - Christophe Sajous
- Department of Medical Oncology, Centre Léon Bérard, Université Claude Bernard Lyon I, Lyon, France
| | - Simon Thezenas
- Department of Biostatistics, Institut du Cancer Montpellier, Univ Montpellier, Montpellier, France
| | | | - Fabien Reyal
- Department of Surgical Oncology, Institut Curie, Paris, France
| | - Marick Laé
- Department of Pathology, Institut Curie, Paris, France
| | - Camille Chakiba
- Department of Medical Oncology, Institut Bergonié, Bordeaux, France
| | - Nicolas Penel
- Department of Medical Oncology, Centre Oscar Lambret, Lille, France
| | | | - Charles Honoré
- Department of Surgical Oncology, Institut Gustave Roussy, Villejuif, France
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Audrey Monneur
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Sébastien Salas
- Department of Medical Oncology, CHU La Timone, Marseille, France
| | - Florence Duffaud
- Department of Medical Oncology, CHU La Timone, Marseille, France
| | - Esma Saada-Bouzid
- Department of Medical Oncology, Centre Antoine Lacassagne, Nice, France
| | - Nicolas Isambert
- Department of Medical Oncology, Centre Georges François Leclerc, Dijon, France
| | - Mehdi Brahmi
- Department of Medical Oncology, Centre Léon Bérard, Université Claude Bernard Lyon I, Lyon, France
| | - Isabelle Ray-Coquard
- Department of Medical Oncology, Centre Léon Bérard, Université Claude Bernard Lyon I, Lyon, France
| | - Jean-Yves Blay
- Department of Medical Oncology, Centre Léon Bérard, Université Claude Bernard Lyon I, Lyon, France
| | - Nelly Firmin
- Department of Medical Oncology, Institut du cancer Montpellier, Univ Montpellier, Montpellier, France
| | | |
Collapse
|
13
|
Kim GE, Kim NI, Park MH, Lee JS. B7-H3 and B7-H4 expression in phyllodes tumors of the breast detected by RNA in situ hybridization and immunohistochemistry: Association with clinicopathological features and T-cell infiltration. Tumour Biol 2018; 40:1010428318815032. [PMID: 30486739 DOI: 10.1177/1010428318815032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Phyllodes tumors are rare biphasic breast tumors with the potential for both local recurrence and distant metastasis. The aberrant expression of B7-H3 and B7-H4 B7 molecules could be potential targets for future development of immunotherapeutic approaches. This work was undertaken to evaluate the expression of B7-H3 and B7-H4 in phyllodes tumors and assess the association with the grade and clinical behavior of phyllodes tumors. In addition, the roles of B7-H3 and B7-H4 in the regulation of tumor immune surveillance were evaluated by assessing the relationship between B7-H3/B7-H4 expression and T-cell infiltration. The messenger RNA and protein expression of B7-H3/B7-H4 were determined by RNAscope in situ hybridization and immunohistochemistry, respectively, in 101 phyllodes tumors (60 benign, 26 borderline, and 15 malignant) using a tissue microarray. Immunohistochemistry for CD3 and CD8 was also performed. B7-H3 messenger RNA and protein appeared to be concentrated mainly in the stromal compartment of phyllodes tumors. However, B7-H4 messenger RNA and protein were undetectable in the stromal compartment of phyllodes tumors. Stromal B7-H3 messenger RNA and protein expression were noted in 10 (16.7%) and 31 (51.7%) of 60 benign phyllodes tumors, 12 (46.1%) and 20 (76.9%) of 26 borderline phyllodes tumors, and 10 (66.7%) and 13 (86.7%) of 15 malignant phyllodes tumors, respectively. Stromal B7-H3 messenger RNA and protein expression increased as phyllodes tumors progressed from benign to borderline and finally to the malignant grade (Pearson's R = 0.411, p < 0.001 and Pearson's R = 0.293, p = 0.003, respectively). The recurrence rate was higher in the stromal B7-H3 messenger RNA or protein-positive group than in the negative group, but this difference was not significant. Stromal B7-H3 protein expression inversely correlated with the densities of CD3+ and CD8+ T-cell infiltrates ( p = 0.001 and p = 0.027, respectively). These results suggest that B7-H3 is involved in the progression of phyllodes tumors and may contribute to their immune surveillance.
Collapse
Affiliation(s)
- Ga-Eon Kim
- 1 Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Nah Ihm Kim
- 1 Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Min Ho Park
- 1 Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea
| | - Ji Shin Lee
- 1 Department of Pathology, Chonnam National University Medical School, Gwangju, South Korea.,3 Department of Pathology, Chonnam National University Hwasun Hospital, Hwasun, South Korea
| |
Collapse
|
14
|
Topcagic J, Feldman R, Ghazalpour A, Swensen J, Gatalica Z, Vranic S. Comprehensive molecular profiling of advanced/metastatic olfactory neuroblastomas. PLoS One 2018; 13:e0191244. [PMID: 29324814 PMCID: PMC5764485 DOI: 10.1371/journal.pone.0191244] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 01/02/2018] [Indexed: 02/06/2023] Open
Abstract
Olfactory neuroblastoma (ONB) is a rare, locally aggressive, malignant neoplasm originating in the olfactory epithelium in the nasal vault. The recurrence rate of ONB remains high and there are no specific treatment guidelines for recurrent/metastatic ONBs. This study retrospectively evaluated 23 ONB samples profiled at Caris Life Sciences (Phoenix, Arizona) using DNA sequencing (Sanger/NGS [Illumina], n = 15) and gene fusions (Archer FusionPlex, n = 6), whole genome RNA microarray (HumanHT-12 v4 beadChip, Illumina, n = 4), gene copy number assays (chromogenic and fluorescent in situ hybridization), and immunohistochemistry. Mutations were detected in 63% ONBs including TP53, CTNNB1, EGFR, APC, cKIT, cMET, PDGFRA, CDH1, FH, and SMAD4 genes. Twenty-one genes were over-expressed and 19 genes under-expressed by microarray assay. Some of the upregulated genes included CD24, SCG2, and IGFBP-2. None of the cases harbored copy number variations of EGFR, HER2 and cMET genes, and no gene fusions were identified. Multiple protein biomarkers of potential response or resistance to classic chemotherapy drugs were identified, such as low ERCC1 [cisplatin sensitivity in 10/12], high TOPO1 [irinotecan sensitivity in 12/19], high TUBB3 [vincristine resistance in 13/14], and high MRP1 [multidrug resistance in 6/6 cases]. None of the cases (0/10) were positive for PD-L1 in tumor cells. Overexpression of pNTRK was observed in 67% (4/6) of the cases without underlying genetic alterations. Molecular alterations detected in our study (e.g., Wnt and cKIT/PDGFRA pathways) are potentially treatable using novel therapeutic approaches. Identified protein biomarkers of response or resistance to classic chemotherapy could be useful in optimizing existing chemotherapy treatment(s) in ONBs.
Collapse
MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- DNA Copy Number Variations
- DNA, Neoplasm/genetics
- Esthesioneuroblastoma, Olfactory/genetics
- Esthesioneuroblastoma, Olfactory/metabolism
- Esthesioneuroblastoma, Olfactory/secondary
- Female
- Gene Expression Profiling
- Gene Fusion
- Humans
- Immunohistochemistry
- In Situ Hybridization, Fluorescence
- Male
- Middle Aged
- Molecular Targeted Therapy
- Mutation
- Nasal Cavity
- Neoplasm Recurrence, Local/genetics
- Neoplasm Recurrence, Local/metabolism
- Neoplasm Recurrence, Local/therapy
- Nose Neoplasms/genetics
- Nose Neoplasms/metabolism
- Nose Neoplasms/therapy
- Retrospective Studies
- Sequence Analysis, DNA
Collapse
Affiliation(s)
- Jasmina Topcagic
- Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Rebecca Feldman
- Caris Life Sciences, Phoenix, Arizona, United States of America
| | | | - Jeffrey Swensen
- Caris Life Sciences, Phoenix, Arizona, United States of America
| | - Zoran Gatalica
- Caris Life Sciences, Phoenix, Arizona, United States of America
| | - Semir Vranic
- Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
- Department of Pathology, Clinical Center and School of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
- College of Medicine, Qatar University, Doha, Qatar
- * E-mail: ,
| |
Collapse
|
15
|
Garcia-Dios DA, Levi D, Shah V, Gillett C, Simpson MA, Hanby A, Tomlinson I, Sawyer EJ. MED12, TERT promoter and RBM15 mutations in primary and recurrent phyllodes tumours. Br J Cancer 2018; 118:277-284. [PMID: 29315289 PMCID: PMC5785756 DOI: 10.1038/bjc.2017.450] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND MED12 and TERT promoter mutations have been shown to be the most common somatic mutations in phyllodes tumours (PTs). The aims of this study were to determine the frequency of these mutations in recurrent PTs, assess whether TERT promoter mutations could be helpful in distinguishing fibroadenomas (FAs) from PTs and identify novel mutations that may be driving malignant progression. METHODS MED12 and the TERT promoter were Sanger sequenced in 75 primary PTs, 21 recurrences, 19 single FAs and 2 cases of multiple FAs with benign PTs. Whole-exome sequencing was performed on one borderline PT. RESULTS Recurrent PTs and multiple FAs showed temporal discordance in MED12 but not TERT. Recurrent samples did acquire TERT mutations, with recurrent benign PTs more likely to have mutations in both genes. TERT mutations were not helpful in differentiating between benign PTs and FAs in cases of multiple FAs/PTs. Exome sequencing revealed a nonsense mutation in RBM15 and Sanger sequencing revealed another three RBM15 mutations in malignant/borderline PTs. CONCLUSIONS This study has shown that MED12 mutations can be heterogeneous in both synchronous and recurrent PTs unlike TERT mutations. We have also shown that RBM15 mutations may be important in the pathogenesis of borderline/malignant PTs.
Collapse
Affiliation(s)
- Diego A Garcia-Dios
- School of Cancer and Pharmaceutical
Sciences, Guy’s Hospital, King’s College London,
London
SE1 9RT, UK
| | - Dina Levi
- School of Cancer and Pharmaceutical
Sciences, Guy’s Hospital, King’s College London,
London
SE1 9RT, UK
| | - Vandna Shah
- School of Cancer and Pharmaceutical
Sciences, Guy’s Hospital, King’s College London,
London
SE1 9RT, UK
| | - Cheryl Gillett
- School of Cancer and Pharmaceutical
Sciences, Guy’s Hospital, King’s College London,
London
SE1 9RT, UK
| | - Michael A Simpson
- Medical and Molecular Genetics,
Guy's Hospital, King’s College London, London,
UK
| | - Andrew Hanby
- Leeds Institute of Cancer and Pathology,
Cancer Genetics Building, St James's University Hospital,
Beckett Street, Leeds
LS9 7TF, UK
| | - Ian Tomlinson
- Institute of Cancer and Genomic Sciences,
University of Birmingham, Edgbaston, Birmingham
B15 2TT, UK
| | - Elinor J Sawyer
- School of Cancer and Pharmaceutical
Sciences, Guy’s Hospital, King’s College London,
London
SE1 9RT, UK
| |
Collapse
|
16
|
Ganesh V, Lee J, Wan BA, Rakovitch E, Vesprini D, Slodkowska E, Zeng KL, Sousa P, Yee C, Chow E. Palliative treatment of metastatic phyllodes tumors: a case series. AME Case Rep 2017; 1:9. [PMID: 30263996 DOI: 10.21037/acr.2017.12.01] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 12/05/2017] [Indexed: 11/06/2022]
Abstract
Up to 20% of malignant phyllodes tumors (PT) metastasize, most frequently to the lungs, bone, and brain. Descriptions of metastatic PT are limited in the literature. In this series, we present three cases of malignant PT metastatic to various unusual sites including the peritoneum, soft tissue of the thigh, and scalp. All three patients initially received surgical resections, and two underwent adjuvant radiation. All three patients developed lung metastases first. Several palliative modalities were used including surgical resection, gamma-knife stereotactic radiosurgery, external beam radiation, and chemotherapy. All three patients died within 3 years of the initial diagnosis.
Collapse
Affiliation(s)
- Vithusha Ganesh
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Justin Lee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Bo Angela Wan
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Eileen Rakovitch
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Danny Vesprini
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Elzbieta Slodkowska
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - K Liang Zeng
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Philomena Sousa
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Caitlin Yee
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Edward Chow
- Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
17
|
Abstract
Fibroepithelial breast lesions encompass a heterogeneous group of neoplasms that range from benign to malignant, each exhibiting differing degrees of stromal proliferation in relation to the epithelial compartment. Fibroadenomas are common benign neoplasms that may be treated conservatively. Phyllodes tumors are relatively rare lesions, and classified as benign, borderline, or malignant based on histologic evaluation of various parameters. The diagnostic interpretation of "gray-zone" fibroepithelial lesions often imposes formidable demands on a pathologist's skills. This article offers practical recommendations for the diagnostic workup of these lesions, including the appropriate utilization of ancillary investigations and the approach to core needle biopsies.
Collapse
|
18
|
Atypical Distant Metastasis of Breast Malignant Phyllodes Tumors: A Case Report and Literature Review. Case Rep Obstet Gynecol 2017; 2017:8963013. [PMID: 29158931 PMCID: PMC5660827 DOI: 10.1155/2017/8963013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 09/11/2017] [Indexed: 11/17/2022] Open
Abstract
Malignant phyllodes tumors (MPT) are rare breast neoplasms. Preoperative diagnosis is often challenging due to the unspecific clinical, radiological, and histological characteristics of the tumor. Dissemination pathways are local with chest wall invasion, regional with lymph nodes metastasis, and distant, hematogenous, mostly to the lungs, bones, and brain. Distant metastasis (DM) can be synchronous or appear months to years after the diagnosis and initial management. The current report describes the case of a 57-year-old woman presenting with a giant/neglected MPT of the breast, with no DM at initial staging, treated by radical modified mastectomy. Motor disorders due to medullar compression by a paravertebral mass appeared at short follow-up, also treated surgically. The patient died from several DM of rapid evolution. To our knowledge, this is the only case described of MPT with metastases to soft tissue causing medullar compression. We present a literature review on unusual metastatic localizations of MPT.
Collapse
|
19
|
Geyer FC, Burke KA, Piscuoglio S, Ng CKY, Papanastasiou AD, Marchiò C, Selenica P, Edelweiss M, Murray MP, Brogi E, Soslow RA, Rubin BP, Norton L, Reis-Filho JS, Weigelt B. Genetic analysis of uterine adenosarcomas and phyllodes tumors of the breast. Mol Oncol 2017; 11:913-926. [PMID: 28267263 PMCID: PMC5537914 DOI: 10.1002/1878-0261.12049] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 02/14/2017] [Accepted: 02/22/2017] [Indexed: 12/17/2022] Open
Abstract
Uterine adenosarcomas and breast phyllodes tumors (PTs) are morphologically similar, being composed of stromal projections in a leaf-like fashion lined by epithelial cells. Here, we investigated whether their histologic similarities would be mirrored at the genetic level. The previously reported repertoires of somatic genetic alterations found in 19 adenosarcomas and 22 PTs (six benign, six borderline, and 10 malignant) were compared. PTs significantly more frequently displayed mutations affecting MED12, the TERT gene promoter and bona fide cancer genes, whereas adenosarcomas harbored a higher rate of MDM2/CDK4 and TERT gene amplifications. Pathway analyses based on the genes affected by somatic genetic alterations in these tumors indicated that Wnt signaling likely plays a role in the biology of adenosarcomas and benign/borderline PTs. In conclusion, despite the differences at the gene level, PTs and adenosarcomas share remarkable morphologic similarities and enrichment for somatic genetic alterations affecting Wnt pathway-related genes.
Collapse
Affiliation(s)
- Felipe C Geyer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kathleen A Burke
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Salvatore Piscuoglio
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charlotte K Y Ng
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | - Pier Selenica
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marcia Edelweiss
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Melissa P Murray
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edi Brogi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert A Soslow
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Brian P Rubin
- Department of Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Larry Norton
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jorge S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| |
Collapse
|
20
|
Ren Q, Jin B. The clinical value and biological function of PTTG1 in colorectal cancer. Biomed Pharmacother 2017; 89:108-115. [PMID: 28219049 DOI: 10.1016/j.biopha.2017.01.115] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 12/12/2022] Open
Abstract
Pituitary tumor transforming gene-1 (PTTG1) has been suggested to serve as an oncogene in several types of human tumors, but little is known about the biological function of PTTG1 in colorectal cancer. PTTG1 mRNA and protein expressions in colorectal cancer tissues and cell lines were measured by qRT-PCR, western blot or immunohistochemistry. The association between PTTG1 protein expression and clinicopathological features was analyzed. The function of PTTG1 on colorectal cancer cell proliferation and metastasis were explored through MTT, colony formation, migration and invasion assays. In our results, PTTG1 mRNA and protein expressions were increased in colorectal cancer tissues and cell lines compared with normal colonic tissues and colon epithelial cell line. PTTG1 overexpression positively associated with clinical stage, T classification, N classification, M classification and differentiation. The univariate and multivariate analyses suggested PTTG1 overexpression was an independent poor prognostic factor for colorectal cancer patients. The in vitro experiments showed knocking down PTTG1 inhibited colorectal cancer growth and metastasis. In conclusion, PTTG1 is an independent prognostic factor and acts as an oncogene in colorectal cancer.
Collapse
Affiliation(s)
- Qinggui Ren
- Division of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China
| | - Bingwei Jin
- Division of General Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai 200233, China.
| |
Collapse
|
21
|
Wang F, Liu Y, Chen Y. Pituitary tumor transforming gene-1 in non-small cell lung cancer: Clinicopathological and immunohistochemical analysis. Biomed Pharmacother 2016; 84:1595-1600. [PMID: 27829547 DOI: 10.1016/j.biopha.2016.10.047] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 10/13/2016] [Accepted: 10/17/2016] [Indexed: 12/12/2022] Open
Abstract
Pituitary tumor transforming gene-1 (PTTG1) is a novel oncogene and overexpressed in a wide variety of human cancers. However, the clinical and prognostic significance of PTTG1 in non-small cell lung cancer (NSCLC) is still unknown. The expression status of PTTG1 in NSCLC at the publicly available GEO databases (GSE19804) was observed. The mRNA and protein expression of PTTG1 in NSCLC tissues and cell lines was detected by qRT-PCR and Western blot, and the association between PTTG1 expression and clinicopathological factors was analyzed by immunohistochemistry. In our Results, PTTG1 was one of genes overexpressed in NCSLC samples compared with paired adjacent normal lung samples in microarray data (GSE19804). PTTG1 mRNA and protein expressions were increased in NSCLC tissues and cell lines. PTTG1 protein expression was correlated with malignant status and poor prognosis of NSCLC patients. In conclusion, PTTG1 is correlated with NSCLC progression and as an independent poor prognostic factor in NSCLC patients.
Collapse
Affiliation(s)
- Feng Wang
- Department of Respiratory Medicine, The First People's Hospital of Shangqiu, Shangqiu 476100, Henan, China
| | - Yanhong Liu
- Department of Respiratory Medicine, The First People's Hospital of Shangqiu, Shangqiu 476100, Henan, China
| | - Yan Chen
- Department of Critical Care Medicine, Shengli Oilfield Center Hospital, Dongying 257034, Shandong, China.
| |
Collapse
|
22
|
El Ochi MR, Toreis M, Benchekroun M, Benkerroum Z, Allaoui M, Ichou M, El Khannoussi B, Albouzidi A, Oukabli M. Bone metastasis from malignant phyllodes breast tumor: report of two cases. BMC Clin Pathol 2016; 16:4. [PMID: 26933383 PMCID: PMC4772458 DOI: 10.1186/s12907-016-0027-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 02/23/2016] [Indexed: 11/20/2022] Open
Abstract
Background Phyllodes tumors are rare fibroepithelial tumors accounting for less than 1 % of all breast neoplasms. They are malignant in 20 % of cases. Only a few cases of malignant phyllodes tumors metastatic to bone have been reported. Case presentation Case 1: A 40 year-old white woman presented with three-week history of pain and functional impairment of the left lower limb. Her clinical past was remarkable for previous left mastectomy and radiotherapy for malignant phyllodes tumor performed one year ago. Computed tomography revealed a moth-eaten appearance of the left femoral head. The patient underwent computed guided femoral head biopsy. Pathological findings were consistent with metastatic malignant phyllodes tumor. The patient received ifosfamide and adriamycin chemotherapy. She is doing well without any evidence of progression on her imaging follow- up after 8 months. Case 2: A 48 year-old white woman, with history of bilateral mastectomy and radiotherapy for malignant phyllodes tumor performed one and two year ago, presented with four-week left lower quadrant abdominal pain. Computed tomography and magnetic resonance imaging revealed a solid aggressive osteolytic mass of the left iliac bone with extensive soft tissue invasion. Biopsy of the tumor was performed and showed a sarcomatous proliferation consistent with metastatic malignant phyllodes tumor. The patient received the same chemotherapy regimen as in the first case but without any response on her imaging follow up after 6 months. Conclusion Malignant phyllodes tumor is a rare and aggressive fibroepithelial neoplasm. An accurate diagnosis of metastases should be based on clinicopathological correlation allowing exclusion of differential diagnoses. The goal of successful managing this tumor is early detection and complete resection prior to dissemination.
Collapse
Affiliation(s)
- Mohamed Reda El Ochi
- Department of Pathology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, BP10000 Rabat, Morocco
| | - Mehdi Toreis
- Department of Medical Oncology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, Rabat, Morocco
| | - Mohamed Benchekroun
- Department of of Orthopaedics and Traumatology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, Rabat, Morocco
| | - Zineb Benkerroum
- Department of of Gynecology and obstetrics, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, Rabat, Morocco
| | - Mohamed Allaoui
- Department of Pathology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, BP10000 Rabat, Morocco
| | - Mohamed Ichou
- Department of Medical Oncology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, Rabat, Morocco
| | - Basma El Khannoussi
- Department of Pathology, National Institute of Oncology, Hay Riad, Faculty of Medicine, Mohamed V University, Rabat, Morocco
| | - Abderrahman Albouzidi
- Department of Pathology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, BP10000 Rabat, Morocco
| | - Mohamed Oukabli
- Department of Pathology, Mohamed V military Hospital, Hay Riad, Faculty of Medicine, Mohamed V University, BP10000 Rabat, Morocco
| |
Collapse
|