Botryoid-type Embryonal Rhabdomyosarcoma: A Comprehensive Clinicopathologic and Molecular Appraisal With Cross-comparison to its Conventional-type Counterpart.
| Autor: | Sharma AE; Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center.; Department of Pathology and Laboratory Medicine, Hospital for Special Surgery., Dermawan JK; Department of Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH., Chiang S; Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center., Wexler LH; Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, NY., Antonescu CR; Department of Pathology & Laboratory Medicine, Memorial Sloan Kettering Cancer Center. |
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| Jazyk: | angličtina |
| Zdroj: | The American journal of surgical pathology [Am J Surg Pathol] 2024 Aug 30. Date of Electronic Publication: 2024 Aug 30. |
| DOI: | 10.1097/PAS.0000000000002300 |
| Abstrakt: | Embryonal rhabdomyosarcoma (ERMS) is the most common subtype of RMS, occurring in soft tissue and visceral sites of young children, and is associated with favorable outcomes. A subset occurs in mucosal-lined luminal structures, displaying a unique grape-like growth termed as "botryoid-type." To further delineate the differences between conventional (cERMS) and botryoid-type (bERMS) RMS, we performed a comparative histologic review and comprehensive molecular profiling of 48 cases (25 bERMS and 23 cERMS). All tumors were subjected to a hybridization capture-based targeted matched tumor-normal DNA NGS assay. The mean age was 17 and 7 years for bERMS and cERMS, respectively. Most bERMS were female with a predilection for the gynecologic tract (75%), while cERMS had a slight male predominance and were preferentially located in abdominopelvic and paratesticular sites (30%, each). All bERMS exhibited an exophytic, bulbous architecture accompanied by a subepithelial "cambium layer." Distinctive germline alterations were detected, with DICER1 (18%) and FH (6%) mutations only in bERMS, and rare TP53, VHL, and APC mutations in cERMS. Similarly, contrasting somatic genomic landscapes were observed, with frequent DICER1 (52%, P**<0.0001) and TP53 (36%, P*<0.05) alterations exclusively in bERMS. Cartilaginous differentiation was only observed in DICER1-mutated bERMS. All patients had longitudinal follow-up. bERMS patients with somatic/germline DICER1 mutations showed significantly improved recurrence-free survival compared with that of DICER1-wild type patients (P*<0.05). Moreover, bERMS showed improved disease-specific survival compared with that of cERMS, with 8% versus 30% (P*<0.05) dead of disease, respectively. In summary, we compare the molecular underpinnings of the largest cohort of bERMS and cERMS with targeted DNA sequencing and long-term follow-up data. Our findings reveal divergent genomic topographies between the 2 groups, with bERMS showing unique germline and somatic abnormalities, including enrichment in DICER1 and TP53 alterations, and a trend towards improved survival. Competing Interests: Conflicts of Interest and Source of Funding: P50 CA217694 (C.R.A.), P30 CA008748 (C.R.A. and L.H.W.), Kristin Ann Carr Foundation (C.R.A.), Cycle for survival (C.R.A. and L.H.W.). For the remaining authors, none were declared. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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