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Sharma AE, Dickson M, Singer S, Hameed MR, Agaram NP. GLI1 Coamplification in Well-Differentiated/Dedifferentiated Liposarcomas: Clinicopathologic and Molecular Analysis of 92 Cases. Mod Pathol 2024; 37:100494. [PMID: 38621503 DOI: 10.1016/j.modpat.2024.100494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/22/2024] [Accepted: 04/08/2024] [Indexed: 04/17/2024]
Abstract
GLI1(12q13.3) amplification is identified in a subset of mesenchymal neoplasms with a distinct nested round cell/epithelioid phenotype. MDM2 and CDK4 genes are situated along the oncogenic 12q13-15 segment, amplification of which defines well-differentiated liposarcoma (WDLPS)/dedifferentiated liposarcoma (DDLPS). The 12q amplicon can occasionally include GLI1, a gene in close proximity to CDK4. We hereby describe the first cohort of GLI1/MDM2/CDK4 coamplified WD/DDLPS. The departmental database was queried retrospectively for all cases of WD/DDLPS having undergone next-generation (MSK-IMPACT) sequencing with confirmed MDM2, CDK4, and GLI1 coamplification. Clinicopathologic data was obtained from a review of the medical chart and available histologic material. Four hundred eighty-six WD/DDLPS cases underwent DNA sequencing, 92 (19%) of which harbored amplification of the GLI1 locus in addition to that of MDM2 and CDK4. These included primary tumors (n = 60), local recurrences (n = 29), and metastases (n = 3). Primary tumors were most frequently retroperitoneal (47/60, 78%), mediastinal (4/60, 7%), and paratesticular (3/60, 5%). Average age was 63 years, with a male:female ratio of 3:2. The cohort was comprised of DDLPS (86/92 [93%], 6 of which were WDLPS with early dedifferentiation) and WDLPS without any longitudinal evidence of dedifferentiation (6/92, 7%). One-fifth (13/86, 17%) of DDLPS cases showed no evidence of a well-differentiated component in any of the primary, recurrent, or metastatic specimens. Dedifferentiated areas mostly showed high-grade undifferentiated pleomorphic sarcoma-like (26/86,30%) and high-grade myxofibrosarcoma-like (13/86,16%) morphologies. A disproportionately increased incidence of meningothelial whorls with/without osseous metaplasia was observed as the predominant pattern in 16/86 (19%) cases, and GLI1-altered morphology as described was identified in a total of 10/86 (12%) tumors. JUN (1p32.1), also implicated in the pathogenesis of WD/DDLPS, was coamplified with all 3 of MDM2, CDK4, and GLI1 in 7/91 (8%) cases. Additional loci along chromosomal arms 1p and 6q, including TNFAIP3, LATS1, and ESR1, were also amplified in a subset of cases. In this large-scale cohort of GLI1 coamplified WD/DDLPS, we elucidate uniquely recurrent features including meningothelial whorl-like and GLI-altered morphology in dedifferentiated areas. Assessment of tumor location (retroperitoneal or mediastinal), identification of a well-differentiated liposarcoma component, and coamplification of other spatially discrete genomic segments (1p and 6q) might aid in distinction from tumors with true driver GLI1 alterations.
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Affiliation(s)
- Aarti E Sharma
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York; Department of Pathology, Hospital for Special Surgery, New York, New York
| | - Mark Dickson
- Department of Medical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Samuel Singer
- Department of Surgical Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Meera R Hameed
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Narasimhan P Agaram
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York.
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Bugeda Gómez P, Costa-Roig A, Montecino Romanini C, Miró Rubio I, Guindos Rúa S, Lara Cárdenas DC, Germani M, Roca Roca M, Romagosa Pérez Portabella C, Garrido Pontnou M, Hernández Losa J, Sanchís Solera LF. Pediatric Plexiform Fibromyxoma: A Case Report. J Pediatr Hematol Oncol 2024; 46:e251-e253. [PMID: 38408159 PMCID: PMC10956666 DOI: 10.1097/mph.0000000000002833] [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: 09/12/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024]
Abstract
The plexiform fibromyxoma is a rare mesenchymal tumor in adults that generally originates in the antrum of stomach, being its occurrence in pediatric patients exceptional. It was classified as a distinct entity by World Health Organization in 2010. No recurrences and metastases have been documented in many of the reported patients to date, being the surgical treatment curative. We report the case of a 3-month-old infant who presented to the emergency department with an episode of intestinal subocclusion requiring an emergent surgery. During the surgical intervention, a mass was identified in the jejunum, causing partial occlusion of its lumen. The surgical pathology report revealed an infiltrative tumor composed of spindle-shaped cells disposed in a stroma with a plexiform pattern alternating myxoid areas. These findings and the immunohistochemical characteristics of the neoplastic cells led to classify the tumor as a plexiform fibromyxoma. A description of the immunophenotype of this tumor is made and differential diagnosis with other gastrointestinal tumors is also discussed.
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Affiliation(s)
| | | | - Carolina Montecino Romanini
- Department of Pathology, Complejo Hospitalario Universitario Insular Materno Infantil, Las Palmas de Gran Canaria, Spain
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McCammon N, Dunn A, Graham R, McHugh J, Lamps L, Bresler SC, Cole T, Rottmann D. Gastroblastoma of the Pylorus: A Case Report and Review of the Literature. Int J Surg Pathol 2023; 31:1516-1521. [PMID: 36823781 DOI: 10.1177/10668969231157310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
Gastroblastoma is an extremely rare biphasic tumor that typically occurs in the stomach in patients between the ages of 10 and 30. Only 16 cases have been reported previously. These tumors are important to diagnose and distinguish from more aggressive neoplasms; although numbers are small, prognosis appears excellent overall with complete excision, with only occasional metastasis and/or local recurrence. We report a case of gastroblastoma in a 26-year-old male arising from the pylorus and extending through the first and second portions of the duodenum. This is the first case to be reported from this specific location.
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Affiliation(s)
- Nathan McCammon
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Andrew Dunn
- Department of Pathology, Hattiesburg Clinic, Hattiesburg, MS, USA
| | - Rondell Graham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jonathan McHugh
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Laura Lamps
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Scott C Bresler
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Thomas Cole
- Comprehensive Radiology Services, PLLC, Hattiesburg, MS, USA
| | - Douglas Rottmann
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
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Yan C, Zhao C, Yang K, Zhou H, Jing L, Zhao W, Dou W, Xia Q, Ma J, Wei B, Guo Y. Rare c-KIT c.1926delA and c.1936T>G Mutations in Exon 13 Define Imatinib Resistance in Gastrointestinal Stromal Tumors and Melanoma Patients: Case Reports and Cell Experiments. Front Mol Biosci 2022; 9:730213. [PMID: 35720122 PMCID: PMC9201753 DOI: 10.3389/fmolb.2022.730213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 04/15/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Target therapies play more and more important roles in gastrointestinal stromal tumors (GISTs) and melanoma with the advancement of clinical drugs that overcome the resistance caused by gene mutations. c-KIT gene mutations account for a large portion of GIST patients, which are known to be sensitive or resistant to tyrosine kinase inhibitors. However, the role rare mutations play in drug efficacy and progression-free duration remains elusive. Methods: Two rare mutations were identified using Sanger sequencing from the GIST and melanoma cases. Cell experiments were further carried out to demonstrate their role in the imatinib resistance. Results:c-KIT c.1926delA p.K642S*FS mutation in primary and recurrent GIST patients and c-KIT c.1936T>G p.Y646D point mutation in melanoma patients in exon 13 were first demonstrated to be novel targets resistant to imatinib agent. Conclusion:c-KIT mutations c.1926delA and c.1936T>G in exon 13 are clinically significant targets that exhibit resistance to imatinib. This study provides guidance to GIST and melanoma treatments.
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Affiliation(s)
- Chi Yan
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
- Henan Key Laboratory of Molecular Pathology, Zhengzhou, China
- *Correspondence: Chi Yan, ; Yongjun Guo,
| | - Chengzhi Zhao
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
- Henan Key Laboratory of Molecular Pathology, Zhengzhou, China
| | - Ke Yang
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
- Henan Key Laboratory of Molecular Pathology, Zhengzhou, China
| | - Hongyan Zhou
- Department of Pathology, Xinxiang First People’s Hospital, Xinxiang, China
| | - Limin Jing
- Computed Tomography Room, Xinxiang First People’s Hospital, Xinxiang, China
| | - Weixing Zhao
- Department of Pathology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Wenguang Dou
- Department of Radiology, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang, China
| | - Qingxin Xia
- Department of Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
| | - Jie Ma
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
- Henan Key Laboratory of Molecular Pathology, Zhengzhou, China
| | - Bing Wei
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
- Henan Key Laboratory of Molecular Pathology, Zhengzhou, China
| | - Yongjun Guo
- Department of Molecular Pathology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China
- Henan Key Laboratory of Molecular Pathology, Zhengzhou, China
- *Correspondence: Chi Yan, ; Yongjun Guo,
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Higashi M, Hamada T, Sasaki K, Tsuruda Y, Shimonosono M, Kitazono I, Kirishima M, Tasaki T, Noguchi H, Tabata K, Hisaoka M, Fukukura Y, Ohtsuka T, Tanimoto A. Esophageal plexiform fibromyxoma: A case report with molecular analysis for MALAT1-GLI1 fusion. Pathol Res Pract 2022; 233:153878. [DOI: 10.1016/j.prp.2022.153878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 02/07/2023]
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Spontaneous hemoperitoneum as a rare presentation of gastric lesions: Two case reports. Int J Surg Case Rep 2022; 91:106769. [PMID: 35091354 PMCID: PMC8801985 DOI: 10.1016/j.ijscr.2022.106769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 01/06/2022] [Accepted: 01/09/2022] [Indexed: 12/31/2022] Open
Abstract
Introduction Spontaneous hemoperitoneum is a rare but life-threatening condition. Clinical presentation is usually nonspecific. The aim of this report is to document a rare clinical presentation of two different intramural stomach tumors. Clinical cases A 40-year-old patient with 24 h epigastric pain was admitted to the emergency, pale, with signs of peritoneal irritation. Computed tomography showed an hemoperitoneum with active bleeding in the posterior wall of the stomach. A wedge resection was performed. Histological report revealed a plexiform fibromyxoma (PF). The second case presents a 79-year-old patient with 24 h abdominal pain, fullness and dizziness, pale and with signs of peritoneal irritation. A voluminous exophytic lesion on gastric wall with active bleeding was diagnosed. Wedge resection was performed and histological report demonstrated a gastrointestinal stromal tumor (GIST). Discussion Imaging plays a role in the diagnosis of spontaneous hemoperitoneum, in elucidating a cause and detecting active hemorrhage. Tumor hemorrhage may be the first presentation of an underlying mass. The presence of a bleeding gastric mass of uncertain nature may result in a challenging situation for the surgeon, who is forced to perform a gastric resection without knowing the exact nature of the tumor and hence the extent of gastric resection required. To our knowledge, our case is the first of PF presenting as hemoperitoneum. Hemoperitoneum is rare as first presentation of GIST, with few cases reported in literature. Conclusion We report two extremely rare cases of spontaneous hemoperitoneum as first presentation of gastric tumor. For the diagnosis a high level of suspicion is required. Spontaneous hemoperitoneum is a rare but life-threatening condition. Tumor hemorrhage may be the first presentation of an underlying gastric mass. This is the first case of Plexiform fibromyxoma (PF) presenting as hemoperitoneum.
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