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Tauziède-Espariat A, Pierre T, Wassef M, Castel D, Riant F, Grill J, Roux A, Pallud J, Dezamis E, Bresson D, Benichi S, Blauwblomme T, Benzohra D, Gauchotte G, Pouget C, Colnat-Coulbois S, Mokhtari K, Balleyguier C, Larousserie F, Dangouloff-Ros V, Boddaert N, Debily MA, Hasty L, Polivka M, Adle-Biassette H, Métais A, Lechapt E, Chrétien F, Sahm F, Sievers P, Varlet P. The dural angioleiomyoma harbors frequent GJA4 mutation and a distinct DNA methylation profile. Acta Neuropathol Commun 2022; 10:81. [PMID: 35642047 PMCID: PMC9153110 DOI: 10.1186/s40478-022-01384-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/17/2022] [Indexed: 11/10/2022] Open
Abstract
The International Society for the Study of Vascular Anomalies (ISSVA) has defined four vascular lesions in the central nervous system (CNS): arteriovenous malformations, cavernous angiomas (also known as cerebral cavernous malformations), venous malformations, and telangiectasias. From a retrospective central radiological and histopathological review of 202 CNS vascular lesions, we identified three cases of unclassified vascular lesions. Interestingly, they shared the same radiological and histopathological features evoking the cavernous subtype of angioleiomyomas described in the soft tissue. We grouped them together with four additional similar cases from our clinicopathological network and performed combined molecular analyses. In addition, cases were compared with a cohort of 5 soft tissue angioleiomyomas. Three out 6 CNS lesions presented the same p.Gly41Cys GJA4 mutation recently reported in hepatic hemangiomas and cutaneous venous malformations and found in 4/5 soft tissue angioleiomyomas of our cohort with available data. Most DNA methylation profiles were not classifiable using the CNS brain tumor (version 12.5), and sarcoma (version 12.2) classifiers. However, using unsupervised t-SNE analysis and hierarchical clustering analysis, 5 of the 6 lesions grouped together and formed a distinct epigenetic group, separated from the clusters of soft tissue angioleiomyomas, other vascular tumors, inflammatory myofibroblastic tumors and meningiomas. Our extensive literature review identified several cases similar to these lesions, with a wide variety of denominations. Based on radiological and histomolecular findings, we suggest the new terminology of "dural angioleiomyomas" (DALM) to designate these lesions characterized by a distinct DNA methylation pattern and frequent GJA4 mutations.
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Affiliation(s)
- Arnault Tauziède-Espariat
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France.
- Inserm, UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France.
| | - Thibaut Pierre
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France
- Department of Radiology, Gustave Roussy, Univ. Paris-Sud, Université Paris-Saclay, 94805, Villejuif, France
| | - Michel Wassef
- Department of Pathology, Lariboisière Hospital, APHP, 75475, Paris, France
| | - David Castel
- U981, Molecular Predictors and New Targets in Oncology, Team Genomics and Oncogenesis of Pediatric Brain Tumors, INSERM, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
- Département de Cancérologie de l'Enfant et de l'Adolescent, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Florence Riant
- Department of Neurovascular Molecular Genetics, Saint-Louis Hospital, APHP, 75010, Paris, France
| | - Jacques Grill
- U981, Molecular Predictors and New Targets in Oncology, Team Genomics and Oncogenesis of Pediatric Brain Tumors, INSERM, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
- Département de Cancérologie de l'Enfant et de l'Adolescent, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Alexandre Roux
- Inserm, UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- Department of Neurosurgery, Sainte-Anne Hospital, 75014, Paris, France
| | - Johan Pallud
- Inserm, UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
- Department of Neurosurgery, Sainte-Anne Hospital, 75014, Paris, France
| | - Edouard Dezamis
- Department of Neurosurgery, Sainte-Anne Hospital, 75014, Paris, France
| | - Damien Bresson
- Department of Neurosurgery, Henri Mondor Hospital, 94000, Créteil, France
| | - Sandro Benichi
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Thomas Blauwblomme
- Department of Pediatric Neurosurgery, Necker Hospital, APHP, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Djallel Benzohra
- Department of Neuroradiology, Sainte-Anne Hospital, 75014, Paris, France
| | | | | | | | - Karima Mokhtari
- Service de Neuropathologie, Institut du Cerveau - Paris Brain Institute - ICM, Inserm, CNRS, Hôpitaux Universitaires La Pitié Salpêtrière - Charles Foix, Sorbonne Université, AP-HP, 75013, Paris, France
| | - Corinne Balleyguier
- Department of Radiology, Gustave Roussy, Univ. Paris-Sud, Université Paris-Saclay, 94805, Villejuif, France
| | - Frédérique Larousserie
- Department of Pathology, Cochin Hospital, AP-HP Paris, Université de Paris, Paris, France
| | - Volodia Dangouloff-Ros
- Paediatric Radiology Department, Institut Imagine INSERM U1163 and U1299, AP-HP, Hôpital Necker Enfants Malades, Université Paris Cité, 75015, Paris, France
| | - Nathalie Boddaert
- Paediatric Radiology Department, Institut Imagine INSERM U1163 and U1299, AP-HP, Hôpital Necker Enfants Malades, Université Paris Cité, 75015, Paris, France
| | - Marie-Anne Debily
- U981, Molecular Predictors and New Targets in Oncology, Team Genomics and Oncogenesis of Pediatric Brain Tumors, INSERM, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
- Département de Cancérologie de l'Enfant et de l'Adolescent, Gustave Roussy, Université Paris-Saclay, 94805, Villejuif, France
| | - Lauren Hasty
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France
| | - Marc Polivka
- Department of Pathology, Lariboisière Hospital, APHP, 75475, Paris, France
| | | | - Alice Métais
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France
- Inserm, UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
| | - Emmanuèle Lechapt
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France
- Department of Pathology, Hôpital Henri-Mondor, INSERM U955, Université Paris-Est, Créteil, France
| | - Fabrice Chrétien
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France
| | - Felix Sahm
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Philipp Sievers
- Department of Neuropathology, Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Clinical Cooperation Unit Neuropathology, German Consortium for Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Pascale Varlet
- Department of Neuropathology, Sainte-Anne Hospital, 1, Rue Cabanis, 75014, Paris, France
- Inserm, UMR 1266, IMA-Brain, Institut de Psychiatrie et Neurosciences de Paris, Paris, France
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Xin Z, Yao Y, Chen G, Wang L, Shu M, Lv Q, Yu H, Zhang T. Fractionated Radiation Therapy for Large and Giant Cavernous Sinus Hemangioma: A Retrospective Study. Front Neurol 2020; 11:355. [PMID: 32477242 PMCID: PMC7237578 DOI: 10.3389/fneur.2020.00355] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 04/09/2020] [Indexed: 11/13/2022] Open
Abstract
Purpose: Surgical resection has been traditionally used as a treatment for cavernous sinus hemangioma (CSH). However, this is usually difficult due to tumor vascularity and results in complications especially in large and giant CSH (volume >20 cm3). Previous studies have reported that radiotherapy (RT) provides an alternative treatment modality for hemangiomas. However, the optimized dose and fractions which control CSH and also protect the cognitive function remain unclear. This study reports our experience in the management of symptomatic large and giant CSH. Methods: Fifty-four patients with symptomatic large (20 cm3 <tumor volume ≤ 40 cm3, 3-4 cm in diameter) and giant (tumor volume>40 cm3, >4 cm in diameter) CSH were enrolled in a retrospective study between January 2007 and December 2018. The prescription dose to the target margin was 50 Gy in 25 fractions. Results: The mean pre-RT tumor volume was 60.9 cm3 which ranged from 20.2 to 230.5 cm3. The clinical data obtained was analyzed retrospectively following a mean follow-up period of 35.0 months which ranged from 1 to 140 months. All patients experienced tumor shrinkage within 3 months after radiotherapy. There was an average mean tumor reduction of 79.7% (range, 48.4-98.5%) with no patients experiencing tumor progression and recurrence. All the 54 patients experienced symptomatic improvement within 1 month to 12 months after radiotherapy. Within the entire follow up period, no patients experienced any form of permanent complications or symptomatic radiation toxicity. Neurocognitive impairment studies were conducted before and after radiotherapy on 28 patients while the studies were conducted after the last follow up in 40 patients. The cognitive function of all the participants had normal MoCA-scores of 28.25 pre-radiotherapy. The post-treatment MoCA-scores were also clinically stable (28.04, p = 0.78), and the average MoCA-score did not show any decline until the last follow-up (27.61, p = 0.13). Conclusion: The optimal dose and fractions of radiotherapy treatment for symptomatic large and giant cavernous sinus hemangioma remain unclear. This study, therefore, used a marginal dose of 50 Gy in 25 fractions in radiotherapy and this was proven to be effective and relatively safe in the treatment of symptomatic large and giant CSHs.
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Affiliation(s)
- Zengfeng Xin
- Department of Radiation Oncology, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China.,Department of Orthopedic Surgery, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Yihan Yao
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Guodi Chen
- Department of Radiation Oncology, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Liancong Wang
- Department of Radiation Oncology, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Meibao Shu
- Department of Radiation Oncology, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China
| | - Qinghua Lv
- Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
| | - Haifeng Yu
- Department of Chemotherapy Center, Zhejiang Cancer Hospital, Hangzhou, China
| | - Ting Zhang
- Department of Radiation Oncology, Zhejiang University School of Medicine, The Second Affiliated Hospital, Zhejiang University, Hangzhou, China.,Key Laboratory of Tumor Microenvironment and Immune Therapy of Zhejiang Province, Hangzhou, China
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