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Mezzacappa FM, Smith FK, Zhang W, Gard A, Cabuk FK, Gonzalez-Gomez I, Monforte HL, Liang J, Singh O, Quezado MM, Aldape KD, Gokden M, Bridge JA, Chen J. Potential prognostic determinants for FET::CREB fusion-positive intracranial mesenchymal tumor. Acta Neuropathol Commun 2024; 12:17. [PMID: 38291529 PMCID: PMC10826246 DOI: 10.1186/s40478-024-01721-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 12/24/2023] [Indexed: 02/01/2024] Open
Abstract
Intracranial mesenchymal tumor (IMT), FET::CREB fusion-positive is a provisional tumor type in the 2021 WHO classification of central nervous system tumors with limited information available. Herein, we describe five new IMT cases from four females and one male with three harboring an EWSR1::CREM fusion and two featuring an EWSR1::ATF1 fusion. Uniform manifold approximation and projection of DNA methylation array data placed two cases to the methylation class "IMT, subclass B", one to "meningioma-benign" and one to "meningioma-intermediate". A literature review identified 74 cases of IMTs (current five cases included) with a median age of 23 years (range 4-79 years) and a slight female predominance (female/male ratio = 1.55). Among the confirmed fusions, 25 (33.8%) featured an EWSR1::ATF1 fusion, 24 (32.4%) EWSR1::CREB1, 23 (31.1%) EWSR1::CREM, one (1.4%) FUS::CREM, and one (1.4%) EWSR1::CREB3L3. Among 66 patients with follow-up information available (median: 17 months; range: 1-158 months), 26 (39.4%) experienced progression/recurrences (median 10.5 months; range 0-120 months). Ultimately, three patients died of disease, all of whom underwent a subtotal resection for an EWSR1::ATF1 fusion-positive tumor. Outcome analysis revealed subtotal resection as an independent factor associated with a significantly shorter progression free survival (PFS; median: 12 months) compared with gross total resection (median: 60 months; p < 0.001). A younger age (< 14 years) was associated with a shorter PFS (median: 9 months) compared with an older age (median: 49 months; p < 0.05). Infratentorial location was associated with a shorter overall survival compared with supratentorial (p < 0.05). In addition, the EWSR1::ATF1 fusion appeared to be associated with a shorter overall survival compared with the other fusions (p < 0.05). In conclusion, IMT is a locally aggressive tumor with a high recurrence rate. Potential risk factors include subtotal resection, younger age, infratentorial location, and possibly EWSR1::ATF1 fusion. Larger case series are needed to better define prognostic determinants in these tumors.
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Affiliation(s)
- Frank M Mezzacappa
- Department of Neurological Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Frankie K Smith
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA
- Department of Pathology, University of Utah and Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Weiwei Zhang
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA
| | - Andrew Gard
- Department of Neurological Surgery, University of Nebraska Medical Center, Omaha, NE, USA
- Department of Neurological Surgery, MD West ONE, Omaha, NE, USA
| | - Fatmagul Kusku Cabuk
- Department of Pathology, Basaksehir Cam and Sakura City Hospital, Başakşehir, Turkey
| | | | - Hector L Monforte
- Division of Pathology, Johns Hopkins All Children's Hospital, Petersburg, FL, USA
| | - Jiancong Liang
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Omkar Singh
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Martha M Quezado
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kenneth D Aldape
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Murat Gokden
- Department of Pathology, University of Arkansas Medical Center, Little Rock, AR, USA
| | - Julia A Bridge
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA
- Division of Molecular Pathology, ProPath, Dallas, TX, USA
| | - Jie Chen
- Department of Pathology, Microbiology, and Immunology, University of Nebraska Medical Center, 983135 Nebraska Medical Center, Omaha, NE, 68198, USA.
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Ozkizilkaya HI, Johnson JM, O’Brien BJ, McCutcheon IE, Prabhu SS, Ghia AJ, Fuller GN, Huse JT, Ballester LY. Intracranial mesenchymal tumor, FET::CREB fusion-positive in the lateral ventricle. Neurooncol Adv 2023; 5:vdad026. [PMID: 37051329 PMCID: PMC10084497 DOI: 10.1093/noajnl/vdad026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Affiliation(s)
- Hanim I Ozkizilkaya
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jason M Johnson
- Division of Diagnostic Imaging, Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Barbara J O’Brien
- Division of Cancer Medicine, Department of Neuro-Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Ian E McCutcheon
- Division of Surgery, Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Sujit S Prabhu
- Division of Surgery, Department of Neurosurgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Amol J Ghia
- Division of Radiation Oncology, Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Gregory N Fuller
- Division of Diagnostic Imaging, Department of Neuroradiology, The University of Texas MD Anderson Cancer Center, Houston, USA
- Division of Pathology and Lab Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jason T Huse
- Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
- Division of Pathology and Lab Medicine, Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Leomar Y Ballester
- Corresponding Author: Leomar Y. Ballester, MD, PhD, Assistant Professor, Neuropathology and Molecular Genetic Pathology, Department of Pathology, Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe, Unit 85, Houston, TX 77030, USA ()
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