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Zheng YJ, Ren L, Zhu Y, Yang X, Zhang X, Deng S, Wang ZQ, Chen D, Shao Y, Han PC, Zhang Q. DICER1-associated sarcoma of the aortic arch - a case report and literature review. Cardiovasc Pathol 2022; 60:107451. [PMID: 35835430 DOI: 10.1016/j.carpath.2022.107451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 06/22/2022] [Accepted: 07/06/2022] [Indexed: 11/29/2022] Open
Abstract
Primary sarcoma of the aorta is extremely rare. We herein report a case of DICER1-associated sarcoma originating from the aortic arch. A 45-year-old male was admitted to the hospital with a cold left hand and weakened radial artery pulse in the left side. Computed tomography of the chest showed multiple penetrating ulcers with tumor-like ectasia at the aortic arch, diagnosed as a pseudoaneurysm. Histopathological analysis of the mass revealed a biphasic neoplasm composed of epithelial and mesenchymal components and a transition zone between the epithelial and mesenchymal cells, which supports the diagnosis of a biphasic sarcoma rather than carcinosarcoma. The differentiated cells of soft tissue showed strong and diffuse positivity for TLE-1, Bcl-2, and CD99; the nested epithelial cells were focally positive for CK-pan, but negative for EMA, membranous localization of β-catenin. This case showed a unique pattern of SS18-break-apart probe, with loss of the green signal (approximately 33%) by fluorescence in situ hybridization (FISH). Fusion gene profiling using whole transcriptome RNA sequencing (RNA-seq) indicated that this case was negative for common fusion genes including SS18. Next-generation sequencing (NGS) revealed somatic mutations in DICER1 . Taken together, this case was diagnosed as a DICER-associated biphasic sarcoma of the aortic arch. The patient died four months after aorta replacement therapy without radiotherapy and chemotherapy.
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Affiliation(s)
- Yan-Jun Zheng
- TEDA Hospital of Tianjin University, pathology department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Ling Ren
- TEDA Hospital of Tianjin University, pathology department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Yu Zhu
- TEDA Hospital of Tianjin University, pathology department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Xi Yang
- TEDA Hospital of Tianjin University, pathology department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Xiang Zhang
- Third central hospital of Tianjin Medical University, radiology department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Shu Deng
- Second Hospital of Tianjin Medical University, stomatology department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Zheng-Qing Wang
- Second Hospital of Tianjin Medical University, stomatology department, Tianjin, China; TEDA international Cardiovascular Hospital of Tianjin University, cardiovascular surgery department, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Dong Chen
- TEDA international Cardiovascular Hospital of Tianjin University, cardiovascular surgery department, Tianjin, China; Affiliated Anzhen Hospital of Capital Medical University, pathology department, Beijing, China; Stomatology colledge, Tianjin Medical University
| | - Yang Shao
- Affiliated Anzhen Hospital of Capital Medical University, pathology department, Beijing, China; Nanjing Geneseeq Technology, Inc, Nanjing, China; School of Public Health, Nanjing Medical University, Nanjing, China; Stomatology colledge, Tianjin Medical University
| | - Peng-Cheng Han
- Department of Pathology, Tianjin Third Central Hospital, Tianjin, China; Stomatology colledge, Tianjin Medical University
| | - Qin Zhang
- TEDA Hospital of Tianjin University, pathology department, Tianjin, China; TEDA international Cardiovascular Hospital of Tianjin University, cardiovascular surgery department, Tianjin, China; Nanjing Geneseeq Technology, Inc, Nanjing, China; School of Public Health, Nanjing Medical University, Nanjing, China; Stomatology colledge, Tianjin Medical University.
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Seo H, Hirai H, Aoyama T, Suehiro Y, Kubota Y, Suehiro S. Undifferentiated intimal sarcoma mimicking a mycotic aneurysm. VASA 2020; 49:243-246. [DOI: 10.1024/0301-1526/a000818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Summary: Intimal sarcoma of arteries is a rare malignant tumor, which often mimics other vascular disorders; therefore, preoperative diagnosis is often challenging. We herein report a 71-year-old man who presented with fever and elevated inflammatory markers who had a mass in the left internal iliac artery with rapid growth. Based on clinical findings, a diagnosis of mycotic aneurysm was made. We performed surgical intervention, including resection of the affected vessels with omentopexy, although intraoperative findings were not typical of a mycotic aneurysm. Microscopic and immunohistochemical examination demonstrated undifferentiated intimal sarcoma. The patient died of multiorgan failure two months after the surgery. The vascular surgeon should consider the possibility of a diagnosis of intimal sarcoma for patients with atypical findings and the importance of histological and immunohistochemical examination for precise diagnosis in surgical vascular cases.
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Affiliation(s)
- Hiroyuki Seo
- Department of Cardiovascular Surgery, Osaka Saiseikai Noe Hospital, Osaka, Japan
| | - Hidekazu Hirai
- Department of Cardiovascular Surgery, Osaka Saiseikai Noe Hospital, Osaka, Japan
| | - Takanobu Aoyama
- Department of Cardiovascular Surgery, Osaka City General Hospital, Osaka, Japan
| | - Yasuo Suehiro
- Department of Cardiovascular Surgery, Osaka Saiseikai Noe Hospital, Osaka, Japan
| | - Yuko Kubota
- Department of Cardiovascular Surgery, Osaka Saiseikai Noe Hospital, Osaka, Japan
| | - Shigefumi Suehiro
- Department of Cardiovascular Surgery, Osaka Saiseikai Noe Hospital, Osaka, Japan
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