关键词: EWSR1-KLF15 Ewing-like sarcoma myoepithelial carcinoma

Mesh : Adult Carcinoma / diagnostic imaging genetics pathology surgery Female Humans Kruppel-Like Transcription Factors / genetics Lymph Nodes / pathology surgery Lymphatic Metastasis Myoepithelioma / diagnostic imaging genetics pathology surgery Neck Nuclear Proteins / genetics Oncogene Proteins, Fusion / genetics Parotid Gland / diagnostic imaging pathology surgery Positron Emission Tomography Computed Tomography RNA-Binding Protein EWS / genetics Sarcoma, Ewing / diagnostic imaging genetics pathology surgery Young Adult

来  源:   DOI:10.1177/1066896918755009

Abstract:
We present a case of a malignant Ewing-like neoplasm of the parotid gland in a 20-year-old woman with an EWSR1-KLF15 gene fusion that presented with pulmonary metastasis. Despite the fact that the tumor was essentially immunohistochemically negative for keratins, p63, and p40, we interpret this neoplasm as an unusual form of a high-grade myoepithelial carcinoma based on its focal plasmacytoid cytology, chondromyxoid matrix, SOX10, S100 protein, and calponin expression, and the knowledge that the EWSR1-KLF15 gene fusion has, to date, only been identified in 2 tumors, both myoepithelial carcinomas of the kidney. We also present a cytogenetic analysis of this unusual tumor. This \"Ewing-like myoepithelial carcinoma\" initially did not respond to 2 cycles of ifosfamide and etoposide alternated with a cycle of cytoxan, adriamycin, and vincristine, a standard regimen for Ewing sarcoma. Subsequent oral pazopanib therapy did result in a reduction of the patient\'s pulmonary and nodal disease.
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