{Reference Type}: Journal Article {Title}: Utility of Retrospective Molecular Analysis in Diagnostically Challenging Mesenchymal Neoplasms. {Author}: Mindiola Romero AE;Tafe LJ;Green DC;Deharvengt SJ;Winnick KN;Tsongalis GJ;Baker ML;Linos K;Levy JJ;Kerr DA; {Journal}: Int J Surg Pathol {Volume}: 31 {Issue}: 8 {Year}: 2023 Dec {Factor}: 1.358 {DOI}: 10.1177/10668969231157783 {Abstract}: Introduction: Molecular analysis plays a growing role in the diagnosis of mesenchymal neoplasms. The aim of this study was to retrospectively apply broad, multiplex molecular assays (a solid tumor targeted next-generation sequencing [NGS]) assay and single nucleotide polymorphism [SNP] microarray) to selected tumors, exploring the current utility and limitations. Methods: We searched our database (2010-2020) for diagnostically challenging mesenchymal neoplasms. After histologic review of available slides, tissue blocks were selected for NGS, SNP microarray, or both. DNA and RNA were extracted using the AllPrep DNA/RNA FFPE Kit Protocol on the QIAcube instrument. The NGS platform used was the TruSight Tumor 170 (TST-170). For SNP array, copy number variant (CNV) analysis was performed using the OncoScanTM CNV Plus Assay. Results: DNA/RNA was successfully extracted from 50% of tumors (nā€‰=ā€‰10/20). Specimens not successfully extracted included 6 core biopsies, 3 incisional biopsies, and 1 resection; 4 were decalcified (3 hydrochloric acid, 1 ethylenediaminetetraacetic acid). Higher tumor proportion and number of tumor cells were parameters positively associated with sufficient DNA/RNA extraction whereas necrosis and decalcification were negatively associated with sufficient extraction. Molecular testing helped reach a definitive diagnosis in 50% of tumors (nā€‰=ā€‰5/10). Conclusions: Although the overall utility of this approach is limited, these molecular panels can be helpful in detecting a specific "driver" alteration.