CASE REPORT
Pigmented/melanocytic malignant perivascular epithelioid cell tumor with TFE3-SFPQ(PSF) rearrangement – a challenging diagnosis of PEComa family of tumors
 
More details
Hide details
1
Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie Institute-Oncology Centre, Warsaw, Poland
 
2
Department of Diagnostic Hematology, Institute of Hematology and Transfusion Medicine, Warsaw, Poland
 
3
Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie Institute-Oncology Centre, Warsaw, Poland
 
 
Publication date: 2020-03-06
 
 
Pol J Pathol 2019;70(4):317-322
 
KEYWORDS
ABSTRACT
We here report a case of a distinct subtype of pigmented/melanocytic malignant PEComa with TFE3-SFPQ(PSF) rearrangement. The tumor involved the iliac region and clinically mimicked metastatic melanoma. The immunohistochemical assessment was supplemented with molecular studies including fluorescence in situ hybridization (FISH) and next-generation sequencing sarcoma panel (NGS). We also discuss the differential diagnosis of intraabdominal PEComas and emphasise the recent molecular reports on the TFE3 rearranged tumors.
REFERENCES (24)
1.
Fletcher CDM, Bridge JA, Hogendoorn PCW, Mertens F. WHO Classification of Tumours of Soft Tissue and Bone WHO/IARC Classification of Tumours. 4th Edition, Volume 5. 2013.
 
2.
Folpe AL, Mentzel T, Lehr HA, et al. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol 2005; 29:1558-1575.
 
3.
Agaram NP, Sung YS, Zhang L, et al. Dichotomy of Genetic Abnormalities in PEComas With Therapeutic Implications. Am J Surg Pathol 2015; 39: 813-825.
 
4.
Maloney N, Giannikou K, Lefferts J, et al. Expanding the histomorphologic spectrum of TFE3-rearranged perivascular epithelioid cell tumors. Human Pathol 2018; 82: 125-130.
 
5.
Rao Q, Shen Q, Xia QY, et al. PSF/SFPQ is a very common gene fusion partner in TFE3 rearrangement-associated perivascular epithelioid cell tumors (PEComas) and melanotic Xp11 translocation renal cancers: clinicopathologic, immunohistochemical, and molecular characteristics suggesting classification as a distinct entity. Am J Surg Pathol 2015; 39: 1181-1196.
 
6.
Shen Q, Rao Q, Xia QY, et al. Perivascular epithelioid cell tumor (PEComa) with TFE3 gene rearrangement: clinicopathological, immunohistochemical, and molecular features. V Arch Virchows 2014; 465: 607-613.
 
7.
Argani P, Aulmann S, Karanjawala Z, et al. Melanotic Xp11 translocation renal cancers: a distinctive neoplasm with overlapping features of PEComa, carcinoma, and melanoma. Am J Surg Pathol 2009; 33: 609-619.
 
8.
Argani P, Zhong M, Reuter VE, et al. TFE3-Fusion Variant Analysis Defines Specific Clinicopathologic Associations Among Xp11 Translocation Cancers. Am J Surg Pathol 2016; 40: 723-737.
 
9.
Kaiserling E, Krober S, Xiao JC, et al. Angiomyolipoma of the kidney. Immunoreactivity with HMB-45. Light- and electron-microscopic findings. Histopathology 1994; 25: 41-48.
 
10.
Park SH, Ro JY, Kim HS, Lee ES. Perivascular epithelioid cell tumor of the uterus: immunohistochemical, ultrastructural and molecular study. Pathology Int 2003; 53: 800-805.
 
11.
Rasalkar DD, Chu WC, Chan AW, et al. Malignant pigmented clear cell epithelioid cell tumor (PEComa) in an adolescent boy with widespread metastases: a rare entity in this age group. Pediatric Radiol 2011; 41: 1587-1590.
 
12.
Ribalta T, Lloreta J, Munne A, et al. Malignant pigmented clear cell epithelioid tumor of the kidney: clear cell (“sugar”) tumor versus malignant melanoma. Human Pathol 2000; 31: 516-519.
 
13.
McGregor SM, Alikhan MB, John RA, et al. Melanotic PEComa of the Sinonasal Mucosa With NONO-TFE3 Fusion: An Elusive Mimic of Sinonasal Melanoma. Am J Surg Pathol 2017; 41: 717-722.
 
14.
Le P, Garg A, Brandao G, et al. Hormonal manipulation with letrozole in the treatment of metastatic malignant pecoma. Curr Oncol (Toronto, Ont) 2014; 21: e518-20.
 
15.
Prizant H, Hammes SR. Minireview: Lymphangioleiomyomatosis (LAM): The “Other” Steroid-Sensitive Cancer. Endocrinology 2016; 157: 3374-3383.
 
16.
Bleeker JS, Quevedo JF, Folpe AL. “Malignant” perivascular epithelioid cell neoplasm: risk stratification and treatment strategies. Sarcoma 2012; 2012: 541626.
 
17.
Gandhi JS, Malik F, Amin MB, et al. MiT family translocation renal cell carcinomas: A 15th anniversary update. Histol Histopathol 2019; 18159.
 
18.
Calio A, Segala D, Munari E, et al. MiT Family Translocation Renal Cell Carcinoma: from the Early Descriptions to the Current Knowledge. Cancers (Basel) 2019; 11: (pii): cancers11081110.
 
19.
Thway K, Fisher C. PEComa: morphology and genetics of a complex tumor family. Ann Diagn Pathol 2015; 19: 359-368.
 
20.
Stacchiotti S, Marrari A, Dei Tos AP, et al. Targeted therapies in rare sarcomas: IMT, ASPS, SFT, PEComa, and CCS. Hematol Oncol Clin North Am 2013; 27: 1049-1061.
 
21.
Wagner AJ, Malinowska-Kolodziej I, Morgan JA, et al. Clinical activity of mTOR inhibition with sirolimus in malignant perivascular epithelioid cell tumors: targeting the pathogenic activation of mTORC1 in tumors. J Clin Oncol 2010; 28: 835-840.
 
22.
Dickson MA, Schwartz GK, Antonescu CR, et al. Extrarenal perivascular epithelioid cell tumors (PEComas) respond to mTOR inhibition: clinical and molecular correlates. Int J Cancer. 2013; 132: 1711-1717.
 
23.
Chowdhury T, Prichard-Jones K, Sebire NJ, et al. Persistent complete response after single-agent sunitinib treatment in a case of TFE translocation positive relapsed metastatic pediatric renal cell carcinoma. J Pediatr Hematol Oncol 2013; 35: e1-3.
 
24.
Stacchiotti S, Negri T, Zaffaroni N, et al. Sunitinib in advanced alveolar soft part sarcoma: evidence of a direct antitumor effect. Ann Oncol 2011; 22: 1682-1690.
 
eISSN:2084-9869
ISSN:1233-9687
Journals System - logo
Scroll to top