Title
Primary intracranial spindle cell sarcoma with rhabdomyosarcoma-like features share a highly distinct methylation profile and DICER1 mutations
Date Issued
01 August 2018
Access level
open access
Resource Type
journal article
Author(s)
Koelsche C.
Mynarek M.
Schrimpf D.
Bertero L.
Serrano J.
Sahm F.
Reuss D.E.
Hou Y.
Baumhoer D.
Vokuhl C.
Flucke U.
Petersen I.
Brück W.
Rutkowski S.
Gessler M.
Diaz Coronado R.Y.
Garcia Leon Juan luis
Tirado O.M.
Mora J.
Alonso J.
Garcia del Muro X.
Esteller M.
Sturm D.
Ecker J.
Milde T.
Pfister S.M.
Korshunov A.
Snuderl M.
Mechtersheimer G.
Schüller U.
Jones D.T.W.
von Deimling A.
Publisher(s)
Springer Verlag
Abstract
Patients with DICER1 predisposition syndrome have an increased risk to develop pleuropulmonary blastoma, cystic nephroma, embryonal rhabdomyosarcoma, and several other rare tumor entities. In this study, we identified 22 primary intracranial sarcomas, including 18 in pediatric patients, with a distinct methylation signature detected by array-based DNA-methylation profiling. In addition, two uterine rhabdomyosarcomas sharing identical features were identified. Gene panel sequencing of the 22 intracranial sarcomas revealed the almost unifying feature of DICER1 hotspot mutations (21/22; 95%) and a high frequency of co-occurring TP53 mutations (12/22; 55%). In addition, 17/22 (77%) sarcomas exhibited alterations in the mitogen-activated protein kinase pathway, most frequently affecting the mutational hotspots of KRAS (8/22; 36%) and mutations or deletions of NF1 (7/22; 32%), followed by mutations of FGFR4 (2/22; 9%), NRAS (2/22; 9%), and amplification of EGFR (1/22; 5%). A germline DICER1 mutation was detected in two of five cases with constitutional DNA available. Notably, none of the patients showed evidence of a cancer-related syndrome at the time of diagnosis. In contrast to the genetic findings, the morphological features of these tumors were less distinctive, although rhabdomyoblasts or rhabdomyoblast-like cells could retrospectively be detected in all cases. The identified combination of genetic events indicates a relationship between the intracranial tumors analyzed and DICER1 predisposition syndrome-associated sarcomas such as embryonal rhabdomyosarcoma or the recently described group of anaplastic sarcomas of the kidney. However, the intracranial tumors in our series were initially interpreted to represent various tumor types, but rhabdomyosarcoma was not among the typical differential diagnoses considered. Given the rarity of intracranial sarcomas, this molecularly clearly defined group comprises a considerable fraction thereof. We therefore propose the designation “spindle cell sarcoma with rhabdomyosarcoma-like features, DICER1 mutant” for this intriguing group.
Start page
327
End page
337
Volume
136
Issue
2
Language
English
OCDE Knowledge area
Oncología
Scopus EID
2-s2.0-85048121325
PubMed ID
Source
Acta Neuropathologica
ISSN of the container
00016322
Source funding
Deutsche Krebshilfe
Sources of information: Directorio de Producción Científica Scopus