1
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Schoettler PJ, Smith CC, Nishitani M, Harris AK, Nelson AT, Watson DA, Kamihara J, Mullen EA, Hill DA, Messinger YH, Fair DB, Kumar KA, Dehner LP, Ash S, Chen KS, Schultz KAP. Anaplastic sarcoma of the kidney (DICER1-sarcoma of the kidney): A report from the International Pleuropulmonary Blastoma/DICER1 Registry. Pediatr Blood Cancer 2024:e31090. [PMID: 38807260 DOI: 10.1002/pbc.31090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/23/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND Anaplastic sarcoma of the kidney (ASK) is a DICER1-related neoplasm first identified as a distinctive tumor type through the evaluation of unusual cases of putative anaplastic Wilms tumors. Subsequent case reports identified the presence of biallelic DICER1 variants as well as progression from cystic nephroma, a benign DICER1-related neoplasm. Despite increasing recognition of ASK as a distinct entity, the optimal treatment remains unclear. METHODS Individuals with known or suspected DICER1-related tumors including ASK were enrolled in the International Pleuropulmonary Blastoma/DICER1 Registry. Additionally, a comprehensive review of reported cases of ASK was undertaken, and data were aggregated for analysis with the aim to identify prognostic factors and clinical characteristics to guide decisions regarding genetic testing, treatment, and surveillance. RESULTS Ten cases of ASK were identified in the Registry along with 37 previously published cases. Staging data, per Children's Oncology Group guidelines, was available for 40 patients: 13 were stage I, 12 were stage II, 10 were stage III, and five were stage IV. Outcome data were available for 37 patients. Most (38 of 46) patients received upfront chemotherapy and 14 patients received upfront radiation. Two-year event-free survival (EFS) for stage I-II ASK was 81.8% (95% confidence interval [CI]: 67.2%-99.6%), compared with 46.6% EFS (95% CI: 24.7%-87.8%) for stage III-IV (p = .07). Two-year overall survival (OS) for stage I-II ASK was 88.9% (95% CI: 75.5%-100.0%), compared with 70.0% (95% CI: 46.7%-100.0%) for stage III-IV (p = .20). Chemotherapy was associated with improved EFS and OS with hazard ratios of 0.09 (95% CI: 0.02-0.31) and 0.08 (95% CI: 0.02-0.42), respectively. CONCLUSION ASK is a rare DICER1-related renal neoplasm. In the current report, we identify clinical and treatment-related factors associated with outcome including the importance of chemotherapy in treating ASK. Ongoing data collection and genomic analysis are indicated to optimize outcomes for children and adults with these rare tumors.
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Affiliation(s)
- Peter J Schoettler
- Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pediatrics and Adolescent Medicine, Division of Hematology-Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Caroline C Smith
- Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Miki Nishitani
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Anne K Harris
- International Pleuropulmonary Blastoma/DICER1 Registry, Children's Minnesota, Minneapolis, Minnesota, USA
- Cancer and Blood Disorders, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Alexander T Nelson
- International Pleuropulmonary Blastoma/DICER1 Registry, Children's Minnesota, Minneapolis, Minnesota, USA
- Cancer and Blood Disorders, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Dave A Watson
- Research Institute, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Junne Kamihara
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Elizabeth A Mullen
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts, USA
| | - D Ashley Hill
- International Pleuropulmonary Blastoma/DICER1 Registry, Children's Minnesota, Minneapolis, Minnesota, USA
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish and St. Louis Children's Hospitals, Washington University Medical Center, St. Louis, Missouri, USA
| | - Yoav H Messinger
- International Pleuropulmonary Blastoma/DICER1 Registry, Children's Minnesota, Minneapolis, Minnesota, USA
- Cancer and Blood Disorders, Children's Minnesota, Minneapolis, Minnesota, USA
| | - Douglas B Fair
- Department of Pediatrics, Division of Hematology/Oncology, Primary Children's Hospital, University of Utah, Salt Lake City, Utah, USA
| | - Kiran A Kumar
- Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Louis P Dehner
- International Pleuropulmonary Blastoma/DICER1 Registry, Children's Minnesota, Minneapolis, Minnesota, USA
- Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish and St. Louis Children's Hospitals, Washington University Medical Center, St. Louis, Missouri, USA
| | - Shifra Ash
- Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Technion-Israel Institute of Technology, Haifa, Israel
| | - Kenneth S Chen
- Department of Pediatrics, Division of Hematology/Oncology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kris Ann P Schultz
- International Pleuropulmonary Blastoma/DICER1 Registry, Children's Minnesota, Minneapolis, Minnesota, USA
- Cancer and Blood Disorders, Children's Minnesota, Minneapolis, Minnesota, USA
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2
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Alhassoun A, Bara AH, Ibrahim MN, Berro SM, Khalil MG. Cystic partially differentiated nephroblastoma in an 18-month-old girl: a case report. Ann Med Surg (Lond) 2023; 85:6148-6151. [PMID: 38098581 PMCID: PMC10718359 DOI: 10.1097/ms9.0000000000001245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 08/20/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction and importance Cystic partially differentiated nephroblastoma (CPDN) is a rare cystic tumor that affects the kidney. It has a low potential for malignancy. It usually presents as an abdominal mass. It may be difficult to confirm the diagnosis of CPDN without a histopathological study. Case presentation The authors report a case of an 18-month-old girl with abdominal distention, which was noticed by her parents. An abdominal computed tomography scan showed a large multilocular cystic mass arising from the lower pole of the left kidney. A left total nephrectomy was performed. Immature blastemal elements without evidence of malignant cells were observed on histological analysis. Conclusion The authors report a case of an 18-month-old girl with CPDN managed by total nephrectomy. CPDN should be considered in the differential diagnosis of patients with cystic renal lesions. The authors would also like to affirm that partial or total nephrectomy should be done in all cases of CPDN and other cystic renal tumors.
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Affiliation(s)
| | - Albaraa H. Bara
- Department of Cardiothoracic Surgery, Damascus University Cardiovascular Surgical Center, Damascus
| | | | - Selman M. Berro
- Department of Pediatric Surgery, Children’s Hospital
- Peoples’ Friendship University of Russia: Rossijskij universitet druzby narodov, Moscow, Russia
| | - Mays G. Khalil
- Department of Otolaryngology, Al-Bassel Hospital, Tartus, Syrian Arab Rebublic
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3
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Quarello P, Carli D, Biasoni D, Gerocarni Nappo S, Morosi C, Cotti R, Garelli E, Zucchetti G, Spadea M, Tirtei E, Spreafico F, Fagioli F. Implications of an Underlying Beckwith-Wiedemann Syndrome for Wilms Tumor Treatment Strategies. Cancers (Basel) 2023; 15:cancers15041292. [PMID: 36831633 PMCID: PMC9954715 DOI: 10.3390/cancers15041292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 02/14/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Beckwith-Wiedemann Syndrome (BWS) is a pediatric overgrowth disorder involving a predisposition to embryonal tumors. Most of the tumors associated with BWS occur in the first 8-10 years of life, and the most common is Wilms tumor (WT). BWS clinical heterogeneity includes subtle overgrowth features or even silent phenotypes, and WT may be the presenting symptom of BWS. WT in BWS individuals exhibit distinct characteristics from those of sporadic WT, and the management of these patients needs a peculiar approach. The most important feature is a higher risk of developing bilateral disease at some time in the course of the illness (synchronous bilateral disease at diagnosis or metachronous recurrence after initial presentation with unilateral disease). Accordingly, neoadjuvant chemotherapy is the recommended approach also for BWS patients with unilateral WT to facilitate nephron-sparing surgical approaches. This review emphasizes the importance of early BWS recognition, particularly if a WT has already occurred, as this will result in an urgent consideration of first-line cancer therapy.
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Affiliation(s)
- Paola Quarello
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
- Correspondence: ; Tel.: +39-011-313-5801
| | - Diana Carli
- Immunogenetics and Transplant Biology Service, Città della Salute e della Scienza University Hospital, 10126 Turin, Italy
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
| | - Davide Biasoni
- Pediatric Surgical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | | | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Roberta Cotti
- Pediatric Radiology, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Emanuela Garelli
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Giulia Zucchetti
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
| | - Manuela Spadea
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Elisa Tirtei
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
| | - Filippo Spreafico
- Pediatric Oncology Unit, Department of Medical Oncology and Hematology, Fondazione IRCCS, Istituto Nazionale dei Tumori, 20133 Milan, Italy
| | - Franca Fagioli
- Pediatric Onco-Hematology, Stem Cell Transplantation and Cellular Therapy Division, Regina Margherita Children’s Hospital, 10126 Turin, Italy
- Department of Public Health and Pediatrics, University of Turin, 10124 Turin, Italy
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4
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Xu L, Wang L, Tian X, Gai Y, Shang N. Spontaneously ruptured multilocular cystic nephroma in an infant. JOURNAL OF CLINICAL ULTRASOUND : JCU 2023; 51:107-109. [PMID: 35862291 DOI: 10.1002/jcu.23267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/15/2022] [Accepted: 06/25/2022] [Indexed: 06/15/2023]
Abstract
We present the case of a 10-month-old girl with spontaneously ruptured cystic nephroma with a 1-week-old abdominal mass and a 1-day history of marked abdominal distension. The tumor presented as gourd-shaped, cystic solid mass in the right kidney with fluid collection. The tumor was successfully removed by urgent surgery. The girl remained in good condition throughout six-month follow-up after.
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Affiliation(s)
- Ling Xu
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Limin Wang
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Xiangying Tian
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Yuanyuan Gai
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
| | - Ning Shang
- Department of Ultrasound, Guangdong Women and Children Hospital, Guangzhou, China
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5
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Aditya M, Chowdhary SK, Kashyap V. Frozen Section Biopsy and Nephron-Sparing Surgery for a Multiloculated Cyst of the Kidney; Is this the Ideal Approach? J Indian Assoc Pediatr Surg 2023; 28:75-79. [PMID: 36910278 PMCID: PMC9997587 DOI: 10.4103/jiaps.jiaps_71_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/08/2022] [Accepted: 08/21/2022] [Indexed: 03/14/2023] Open
Abstract
Multiloculated cystic renal masses are uncommon in the pediatric population. The presentation may be as an asymptomatic incidental finding on imaging, abdominal mass, abdominal pain, or urinary tract infection. The differentiation between benign and malignant causes of a cystic lesion by clinical and radiological examination is difficult. Tru-cut biopsy is not recommended due to fear of upgrading a malignant tumor. A definitive diagnosis is confirmed histopathologically only after surgery. Based on certain imaging characteristics, benign nature can be suspected and a conservative approach to surgery can be contemplated to save the kidney. Frozen section biopsy is useful in ruling out malignancy while doing nephron-sparing surgery (NSS) in these patients. NSS may be done by an open or minimally invasive approach. After histological confirmation of cystic nephroma, no other adjuvant treatment is necessary, but long-term surveillance is strongly recommended.
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Affiliation(s)
- M. Aditya
- Department of Pediatric Urology and Pediatric Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - Sujit K. Chowdhary
- Department of Pediatric Urology and Pediatric Surgery, Indraprastha Apollo Hospitals, New Delhi, India
| | - Vikas Kashyap
- Department of Histopathology, Indraprastha Apollo Hospitals, New Delhi, India
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6
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Jackson TJ, Brisse HJ, Pritchard-Jones K, Nakata K, Morosi C, Oue T, Irtan S, Vujanic G, van den Heuvel-Eibrink MM, Graf N, Chowdhury T. How we approach paediatric renal tumour core needle biopsy in the setting of preoperative chemotherapy: A Review from the SIOP Renal Tumour Study Group. Pediatr Blood Cancer 2022; 69:e29702. [PMID: 35587187 DOI: 10.1002/pbc.29702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 12/22/2022]
Abstract
The International Society of Paediatric Oncology Renal Tumour Study Group (SIOP-RTSG) advocate treating children with Wilms tumour (WT) with preoperative chemotherapy, whereas the Renal Tumor Committee of the Children's Oncology Group (COG) advocates primary nephrectomy (without biopsy) when feasible. Successive SIOP-RTSG trial protocols recommended pretreatment biopsy of children with unilateral tumours only where there were features to suggest an increased probability of a non-WT requiring a change in management. The UK experience in the SIOP WT 2001 trial showed that an alternate approach of performing biopsies on all children with renal tumour masses to determine histology at diagnosis rarely changes management, and can result in misdiagnosis (particularly patients in the age range typical for WT). Although a more selective approach to biopsy has been routine practice in all other countries participating in SIOP-RTSG trials, there was variation between national groups. To address this variation and provide evidence-based recommendations for the indications and recommended approach to renal tumour biopsy within the SIOP paradigm, an international, multidisciplinary working group of SIOP-RTSG members was convened. We describe the resulting recommendations of this group, which are to be incorporated in the ongoing SIOP-RTSG UMBRELLA study.
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Affiliation(s)
- Thomas J Jackson
- UCL Great Ormond Street Institute for Child Health, London, UK
- North Middlesex Hospital NHS Trust, London, UK
| | - Herve J Brisse
- Imaging Department, Institut Curie, Paris, France
- Laboratoire d'Imagerie Translationnelle en Oncologie (LITO), Inserm U1288, Paris-Saclay University, Paris, France
| | | | - Kayo Nakata
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Carlo Morosi
- Department of Radiology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Takahara Oue
- Department of Pediatric Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - Sabine Irtan
- Neonatal and Visceral Pediatric Surgery Department, Sorbonne Université, Hôpital Armand Trousseau - Assistance Publique Hôpitaux de Paris, Paris, France
| | | | | | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany
| | - Tanzina Chowdhury
- UCL Great Ormond Street Institute for Child Health, London, UK
- Great Ormond Street Hospital for Children, London, UK
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7
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Roy P, van Peer SE, de Witte MM, Tytgat GAM, Karim-Kos HE, van Grotel M, van de Ven CP, Mavinkurve-Groothuis AMC, Merks JHM, Kuiper RP, Hol JA, Janssens GOR, de Krijger RR, Jongmans MCJ, Drost J, van der Steeg AFW, Littooij AS, Wijnen MHWA, van Tinteren H, van den Heuvel-Eibrink MM. Characteristics and outcome of children with renal tumors in the Netherlands: The first five-year's experience of national centralization. PLoS One 2022; 17:e0261729. [PMID: 35025887 PMCID: PMC8757983 DOI: 10.1371/journal.pone.0261729] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/08/2021] [Indexed: 01/20/2023] Open
Abstract
Around 6% of all childhood malignancies represent renal tumors, of which a majority includes Wilms tumor (WT). Although survival rates have improved over the last decades, specific patients are still at risk for adverse outcome. In the Netherlands, since 2015, pediatric oncology care for renal tumors has been centralized in the Princess Máxima Center for Pediatric Oncology. Here, we describe experiences of the first 5 years of centralized care and explore whether this influences the epidemiological landscape by comparing data with the Netherlands Cancer Registry (NCR). We identified all patients <19 years with a renal mass diagnosed between 01-01-2015 and 31-12-2019 in the Princess Máxima Center. Epidemiology, characteristics and management were analyzed. We identified 164 patients (including 1 patient who refused consent for registration), in our center with a suspicion of a renal tumor. The remaining 163 cases included WT (n = 118)/cystic partially differentiated nephroblastoma (n = 2)/nephrogenic rests only (n = 6) and non-WT (n = 37). In this period, the NCR included 138 children, 1 17-year-old patient was not referred to the Princess Máxima Center. Central radiology review (before starting treatment) was performed in 121/163 patients, and central pathology review in 148/152 patients that underwent surgery. Treatment stratification, according to SIOP/EpSSG protocols was pursued based on multidisciplinary consensus. Preoperative chemotherapy was administered in 133 patients, whereas 19 patients underwent upfront surgery. Surgery was performed in 152 patients, and from 133 biomaterial was stored. Centralization of care for children with renal tumors led to referral of all but 1 new renal tumor cases in the Netherlands, and leads to referral of very rare subtypes not registered in the NCR, that benefit from high quality diagnostics and multidisciplinary decision making. National centralization of care led to enhanced development of molecular diagnostics and other innovation-based treatments for the future.
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Affiliation(s)
- Prakriti Roy
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- * E-mail:
| | | | | | | | - Henrike E. Karim-Kos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Research and Development, Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, The Netherlands
| | | | | | | | | | - Roland P. Kuiper
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Clinical Genetics, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Janna A. Hol
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Geert O. R. Janssens
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Radiation Oncology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Ronald R. de Krijger
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pathology, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Marjolijn C. J. Jongmans
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Clinical Genetics, University Medical Center Utrecht (UMCU), Utrecht, The Netherlands
| | - Jarno Drost
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Oncode Institute, Utrecht, The Netherlands
| | | | - Annemieke S. Littooij
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht/Wilhelmina Children’s Hospital (UMCU), Utrecht, The Netherlands
| | | | - Harm van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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8
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González IA, Stewart DR, Schultz KAP, Field AP, Hill DA, Dehner LP. DICER1 tumor predisposition syndrome: an evolving story initiated with the pleuropulmonary blastoma. Mod Pathol 2022; 35:4-22. [PMID: 34599283 PMCID: PMC8695383 DOI: 10.1038/s41379-021-00905-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/09/2021] [Accepted: 08/09/2021] [Indexed: 02/06/2023]
Abstract
DICER1 syndrome (OMIM 606241, 601200) is a rare autosomal dominant familial tumor predisposition disorder with a heterozygous DICER1 germline mutation. The most common tumor seen clinically is the pleuropulmonary blastoma (PPB), a lung neoplasm of early childhood which is classified on its morphologic features into four types (IR, I, II and III) with tumor progression over time within the first 4-5 years of life from the prognostically favorable cystic type I to the unfavorable solid type III. Following the initial report of PPB, its association with other cystic neoplasms was demonstrated in family studies. The detection of the germline mutation in DICER1 provided the opportunity to identify and continue to recognize a number seemingly unrelated extrapulmonary neoplasms: Sertoli-Leydig cell tumor, gynandroblastoma, embryonal rhabdomyosarcomas of the cervix and other sites, multinodular goiter, differentiated and poorly differentiated thyroid carcinoma, cervical-thyroid teratoma, cystic nephroma-anaplastic sarcoma of kidney, nasal chondromesenchymal hamartoma, intestinal juvenile-like hamartomatous polyp, ciliary body medulloepithelioma, pituitary blastoma, pineoblastoma, primary central nervous system sarcoma, embryonal tumor with multilayered rosettes-like cerebellar tumor, PPB-like peritoneal sarcoma, DICER1-associated presacral malignant teratoid neoplasm and other non-neoplastic associations. Each of these neoplasms is characterized by a second somatic mutation in DICER1. In this review, we have summarized the salient clinicopathologic aspects of these tumors whose histopathologic features have several overlapping morphologic attributes particularly the primitive mesenchyme often with rhabdomyoblastic and chondroid differentiation and an uncommitted spindle cell pattern. Several of these tumors have an initial cystic stage from which there is progression to a high grade, complex patterned neoplasm. These pathologic findings in the appropriate clinical setting should serve to alert the pathologist to the possibility of a DICER1-associated neoplasm and initiate appropriate testing on the neoplasm and to alert the clinician about the concern for a DICER1 mutation.
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Affiliation(s)
- Iván A. González
- grid.239552.a0000 0001 0680 8770Department of Pathology and Laboratory Medicine, Children’s Hospital of Philadelphia, Philadelphia, PA USA
| | - Douglas R. Stewart
- grid.48336.3a0000 0004 1936 8075Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD USA
| | - Kris Ann P. Schultz
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN USA ,Cancer and Blood Disorders, Children’s Minnesota, Minneapolis, MN USA
| | | | - D. Ashley Hill
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN USA ,ResourcePath LLC, Sterling, VA USA ,grid.253615.60000 0004 1936 9510Division of Pathology, Children’s National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC USA
| | - Louis P. Dehner
- International Pleuropulmonary Blastoma/DICER1 Registry, Children’s Minnesota, Minneapolis, MN USA ,grid.411019.cThe Lauren V. Ackerman Laboratory of Surgical Pathology, Barnes-Jewish and St. Louis Children’s Hospitals, Washington University Medical Center, St. Louis, MO USA
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9
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Chao L, Lei Z, Xiang L, Qi Z. Pediatric unicystic cystic partially differentiated nephroblastoma: The first case report. Front Pediatr 2022; 10:1045936. [PMID: 36523393 PMCID: PMC9745052 DOI: 10.3389/fped.2022.1045936] [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: 09/16/2022] [Accepted: 11/08/2022] [Indexed: 11/30/2022] Open
Abstract
Cases of patients with cystic partially differentiated nephroblastoma (CPDN) have been reported to date, which presented as polycystic renal tumor in all of them. It is a special pathological type of nephroblastoma. Here, we report the first case of a unicystic CPDN in a child. The patient was diagnosed with a simple renal cyst and underwent laparoscopic decortication. The naive nephron was found in the pathological section, and the diagnosis of CPDN was confirmed. The patient then underwent a radical nephrectomy and six cycles of postoperative chemotherapy. There was no recurrence or metastasis after 2 years of follow-up. Pediatric CPDN presenting as a unicystic renal tumor poses a new challenge to the diagnosis, differential diagnosis, and treatment of unicystic renal tumor.
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Affiliation(s)
- Liu Chao
- Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Zhang Lei
- Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Li Xiang
- Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China
| | - Zhou Qi
- Department of Pediatric Surgery, Qilu Hospital, Shandong University, Jinan, China
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10
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Graf N, Bergeron C, Brok J, de Camargo B, Chowdhury T, Furtwängler R, Gessler M, Godzinski J, Pritchard-Jones K, Ramirez-Villar GL, Rübe C, Sandstedt B, Schenk JP, Spreafico F, Sudour-Bonnange H, van Tinteren H, Verschuur A, Vujanic G, van den Heuvel-Eibrink MM. Fifty years of clinical and research studies for childhood renal tumors within the International Society of Pediatric Oncology (SIOP). Ann Oncol 2021; 32:1327-1331. [PMID: 34416363 DOI: 10.1016/j.annonc.2021.08.1749] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 08/08/2021] [Indexed: 01/01/2023] Open
Affiliation(s)
- N Graf
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany.
| | - C Bergeron
- Department of Paediatric Haemato-Oncology, Centre Léon Bérard, Lyon, France
| | - J Brok
- Department of Pediatric Oncology and Hematology, Rigshospitalet, Copenhagen, Denmark
| | - B de Camargo
- Research Center, Instituto Nacional do Cancer, Rio de Janeiro, Brazil
| | - T Chowdhury
- Department of Haematology and Oncology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - R Furtwängler
- Department of Pediatric Oncology and Hematology, Saarland University, Homburg, Germany
| | - M Gessler
- Theodor-Boveri-Institute/Biocenter and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
| | - J Godzinski
- Department of Pediatric Surgery, Marciniak Hospital, Fieldorfa 2, Poland; Department of Paediatric Traumatology and Emergency Medicine, Wroclaw Medical University, Wroclaw, Poland
| | - K Pritchard-Jones
- Developmental Biology and Cancer Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, University College London, London, UK
| | - G L Ramirez-Villar
- Department of Paediatric Oncology, Hospital Universitario Virgen del Rocío, Seville, Spain
| | - C Rübe
- Department of Radiation Oncology, Saarland University, Homburg, Germany
| | - B Sandstedt
- Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden
| | - J-P Schenk
- Pediatric Radiology Section, Department for Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - F Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - H Sudour-Bonnange
- Centre Oscar Lambret, Department of Children and AJA Oncology, Lille, France
| | - H van Tinteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands
| | - A Verschuur
- Department of Pediatric Oncology, Hôpital d'Enfants de la Timone, Marseille, France
| | - G Vujanic
- Department of Pathology, Sidra Medicine and Weill Cornell Medicine - Qatar, Doha, Qatar
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