J 2022

Epithelioid Soft Tissue Neoplasm of the Soft Palate with a PTCH1-GLI1 Fusion: A Case Report and Review of the Literature

KLUBICKOVA, Natalie, Zdenek KINKOR, Michael MICHAL, Martina BANECKOVA, Veronika HAJKOVA et. al.

Basic information

Original name

Epithelioid Soft Tissue Neoplasm of the Soft Palate with a PTCH1-GLI1 Fusion: A Case Report and Review of the Literature

Authors

KLUBICKOVA, Natalie (203 Czech Republic, guarantor), Zdenek KINKOR (203 Czech Republic), Michael MICHAL (203 Czech Republic), Martina BANECKOVA (203 Czech Republic), Veronika HAJKOVA (203 Czech Republic), Jaroslav MICHALEK (203 Czech Republic), Richard PINK (203 Czech Republic), Zdeněk DVOŘÁK (203 Czech Republic, belonging to the institution), Michal MICHAL (203 Czech Republic), Ilmo LEIVO and Alena SKALOVA (203 Czech Republic)

Edition

HEAD & NECK PATHOLOGY, NEW YORK, SPRINGER, 2022, 1936-055X

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30109 Pathology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

Impact factor

Impact factor: 2.100

RIV identification code

RIV/00216224:14110/22:00125394

Organization unit

Faculty of Medicine

UT WoS

000707690400005

Keywords in English

Epithelioid soft tissue neoplasm; Oral cavity; PTCH1-GLI1 gene fusion; Soft palate; S100 protein; Hedgehog signaling pathway

Tags

Tags

International impact, Reviewed
Změněno: 3/4/2023 08:55, Mgr. Tereza Miškechová

Abstract

V originále

GLI1 fusions involving ACTB, MALAT1, PTCH1 and FOXO4 genes have been reported in a subset of malignant mesenchymal tumors with a characteristic nested epithelioid morphology and frequent S100 positivity. Typically, these multilobulated tumors consist of uniform epithelioid cells with bland nuclei and are organized into distinct nests and cords with conspicuously rich vasculature. We herein expand earlier findings by reporting a case of a 34-year-old female with an epithelioid mesenchymal tumor of the palate. The neoplastic cells stained positive for S100 protein and D2-40, whereas multiple other markers were negative. Genetic alterations were investigated by targeted RNA sequencing, and a PTCH1-GLI1 fusion was detected. Epithelioid mesenchymal tumors harboring a PTCH1-GLI1 fusion are vanishingly rare with only three cases reported so far. Due to the unique location in the mucosa of the soft palate adjacent to minor salivary glands, multilobulated growth, nested epithelioid morphology, focal clearing of the cytoplasm, and immunopositivity for S100 protein and D2-40, the differential diagnoses include primary salivary gland epithelial tumors, in particular myoepithelioma and myoepithelial carcinoma. Another differential diagnostic possibility is the ectomesenchymal chondromyxoid tumor. Useful diagnostic clues for tumors with a GLI1 rearrangement include a rich vascular network between the nests of neoplastic cells, tumor tissue bulging into vascular spaces, and absence of SOX10, GFAP and cytokeratin immunopositivity. Identifying areas with features of GLI1-rearranged tumors should trigger subsequent molecular confirmation. This is important for appropriate treatment measures as PTCH1-GLI1 positive mesenchymal epithelioid neoplasms have a propensity for locoregional lymph node and distant lung metastases.