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细胞外骨骼黏液样软骨肉瘤中 KIT 突变:病例报告及文献复习。

Mutation of KIT in cellular extraskeletal myxoid chondrosarcoma: a case report and literature review.

机构信息

Department of Pathology, Fujian Provincial Hospital, Shengli Clinical Medical College of Fujian Medical University, NO. 134, East Street, Gulou District, 350001, Fuzhou, Fujian Province, China.

Department of Pathology, Fujian Provincial Hospital South Branch, 350028, Fuzhou, Fujian Province, China.

出版信息

Diagn Pathol. 2022 Apr 29;17(1):42. doi: 10.1186/s13000-022-01222-7.

Abstract

BACKGROUND

Extraskeletal myxoid chondrosarcomas (EMCs) are solid tumors that have been genetically and biologically characterized. Only a few studies have discussed the role of the KIT gene or CD117 expression in EMCs, identified by immunohistochemical (IHC) staining. Herein, we present a novel case of cellular EMC exhibiting an EWSR1-NR4A3 fusion, KIT exon 13 mutations and strong diffuse expression of CD117.

CASE PRESENTATION

A 69-year-old man presented with a fist-sized tumor on his left shoulder. CT revealed a tumor in the left thoracic and dorsal muscle space. The tumor was completely resected. Histologically, the tumor cells had a nodular structure and infiltrated the peripheral fat and muscle tissues. The tumor cells were uniform in size with round nuclei, well-defined nucleoli and eosinophilic cytoplasm. Immunohistochemically, the tumor cells were positive for CD117, vimentin, CD56 and NSE and focally expressed desmin; the cells were negative for myogenin, S-100, SYN, INSM1, CD34, STAT6, INI-1, Brachyury, ERG, TLE1, AE1/AE3, WT-1, CD99 and SMA. NGS revealed an EWSR1-NR4A3 fusion and KIT exon 13 mutations. The patient had no further treatment after surgery, and no recurrence or metastasis occurred during the ~ 10 month follow-up period.

CONCLUSIONS

Molecular detection is an indispensable technique for diagnosing cellular EMCs. The KIT mutations noted in this case report may offer fresh insights into EMCs treatment options.

摘要

背景

骨外黏液样软骨肉瘤(EMCs)是一种已在遗传学和生物学上得到明确界定的实体肿瘤。仅有少数研究讨论了 KIT 基因或 CD117 表达在 EMCs 中的作用,这些作用是通过免疫组织化学(IHC)染色来确定的。在此,我们报告了一例具有 EWSR1-NR4A3 融合、KIT 外显子 13 突变和 CD117 强弥漫性表达的细胞型 EMC 的新病例。

病例介绍

一名 69 岁男性,左肩部出现一个拳头大小的肿瘤。CT 显示左胸背部肌间隙有一个肿瘤。肿瘤被完全切除。组织学上,肿瘤细胞呈结节状结构,浸润外周脂肪和肌肉组织。肿瘤细胞大小均匀,圆形核,核仁明显,嗜酸性细胞质。免疫组织化学染色显示,肿瘤细胞 CD117、波形蛋白、CD56 和 NSE 阳性,局灶性表达结蛋白;细胞不表达肌球蛋白、S-100、SYN、INSM1、CD34、STAT6、INI-1、Brachyury、ERG、TLE1、AE1/AE3、WT-1、CD99 和 SMA。NGS 显示 EWSR1-NR4A3 融合和 KIT 外显子 13 突变。患者手术后未进行进一步治疗,在约 10 个月的随访期间未出现复发或转移。

结论

分子检测是诊断细胞型 EMCs 不可或缺的技术。本病例报告中发现的 KIT 突变可能为 EMCs 的治疗选择提供新的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/18b3/9052449/302f78fa74df/13000_2022_1222_Fig1_HTML.jpg

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