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Pericytoma With t(7;12) and ACTB-GLI1 Fusion: Reevaluation of an Unusual Entity and its Relationship to the Spectrum of GLI1 Fusion-related Neoplasms.

Abstract
The entity "pericytoma with t(7;12)" was described as a rare, distinct perivascular myoid neoplasm provisionally classified within the family of myopericytic tumors that demonstrates t(7;12)(p22;q13) translocation with resultant ACTB-GLI1 fusion and biologically was felt to behave in an indolent fashion. However, a recent study showed that tumors with this and similar translocations may have variable morphology and immunohistochemical phenotype with inconsistent myopericytic characteristics and a propensity for metastasis, raising questions regarding the most appropriate classification of these neoplasms. Herein, we report 3 additional patients with tumors harboring t(7;12) and ACTB-GLI1 fusion. The tumors arose in adults and involved the proximal tibia and adjacent soft tissues, scapula and adjacent soft tissues, and ovary. All tumors were composed of round-to-ovoid cells with a richly vascularized stroma with many small, delicate, branching blood vessels, where the neoplastic cells were frequently arranged in a perivascular distribution. Both tumors involving bone showed histologic features of malignancy. By immunohistochemistry, all tested tumors were at least focally positive for smooth muscle actin (3/3) and CD99 (patchy) (2/2), with variable staining for muscle-specific actin (2/3), S100 protein (1/3), epithelial membrane antigen (2/3), and pan-keratin (1/3); all were negative for desmin and WT1 (0/3). The 2 patients with bone tumors developed metastases (27 and 84 mo after diagnosis). Whether these tumors are best classified as malignant myopericytoma variants or an emerging translocation-associated sarcoma of uncertain differentiation remains to be fully clarified; however, our study further documents the potential for these tumors to behave in an aggressive fashion, sometimes over a prolonged clinical course.
AuthorsDarcy A Kerr, Andre Pinto, Ty K Subhawong, Breelyn A Wilky, Matthew P Schlumbrecht, Cristina R Antonescu, G Petur Nielsen, Andrew E Rosenberg
JournalThe American journal of surgical pathology (Am J Surg Pathol) Vol. 43 Issue 12 Pg. 1682-1692 (12 2019) ISSN: 1532-0979 [Electronic] United States
PMID31567194 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Actins
  • Biomarkers, Tumor
  • GLI1 protein, human
  • Zinc Finger Protein GLI1
Topics
  • Actins (genetics)
  • Adult
  • Biomarkers, Tumor (genetics)
  • Bone Neoplasms (classification, genetics, pathology, therapy)
  • Cell Differentiation
  • Chromosomes, Human, Pair 12
  • Chromosomes, Human, Pair 7
  • Female
  • Gene Fusion
  • Genetic Predisposition to Disease
  • Humans
  • Male
  • Middle Aged
  • Myopericytoma (classification, genetics, secondary, therapy)
  • Ovarian Neoplasms (classification, genetics, pathology, therapy)
  • Phenotype
  • Sarcoma (classification, genetics, secondary, therapy)
  • Translocation, Genetic
  • Treatment Outcome
  • Zinc Finger Protein GLI1 (genetics)

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