Rhabdoid Tumor

横纹肌样瘤
  • 文章类型: Journal Article
    背景:具有横纹肌样特征的类似于卵巢性索肿瘤(UTROSCT)的子宫肿瘤是不常见的间充质肿瘤,表现出不同的组织学模式,包括显著的横纹肌形态。彻底了解其临床病理特征对于准确诊断和有效管理至关重要。
    方法:本研究报告4例具有横纹肌样特征的UTROSCT,在31至58岁的患者中诊断。观察到不同的复发模式,包括与原发肿瘤相似的复发病变,随后死亡,初始浸润和淋巴结转移,只有原发性肿瘤的存在。
    方法:组织病理学检查显示不同的形态学模式,突出的特征是横纹肌样分化。免疫组织化学分析显示激素受体表达,性索,平滑肌,和上皮标记,特别是WT1、CD56和CD99。分子分析确定ESR1-NCOA2融合和ESR1和NCOA2/3重排,表明这些遗传改变与广泛的横纹肌样分化之间存在潜在的关联。
    方法:复发后给予各种治疗,包括化疗和靶向治疗。然而,所有病例的临床结局均较差.
    结果:尽管积极治疗,包括化疗和靶向治疗,观察到不良的临床结果,突出了UTROSCT的侵袭性,并伴有明显的横纹肌样分化。
    结论:本病例系列强调详细病理报告的重要性,全面的分子检测,在具有横纹肌样特征的UTROSCT病例中进行彻底的肿瘤分期。增强对具有横纹肌样分化的UTROSCT的临床病理特征的了解对于准确诊断至关重要。预测,和管理策略。
    BACKGROUND: Uterine tumors resembling ovarian sex cord tumors (UTROSCT) with rhabdoid features are uncommon mesenchymal neoplasms exhibiting diverse histological patterns, including significant rhabdoid morphology. A thorough comprehension of their clinicopathologic features is crucial for precise diagnosis and effective management.
    METHODS: This study presents 4 cases of UTROSCT with rhabdoid features, diagnosed in patients aged 31 to 58. Varied recurrence patterns were observed, including similar recurrent lesions to the primary tumors with subsequent mortality, initial invasion and lymph node metastasis, and presence of only primary tumor.
    METHODS: Histopathological examination revealed diverse morphological patterns, prominently featuring rhabdoid differentiation. Immunohistochemical analysis showed expression of hormone receptors, sex cord, smooth muscle, and epithelial markers, notably WT1, CD56, and CD99. Molecular analysis identified ESR1-NCOA2 fusions and ESR1 and NCOA2/3 rearrangements, indicating a potential association between these genetic alterations and extensive rhabdoid differentiation.
    METHODS: Various treatments were administered post-recurrence, including chemotherapy and targeted therapies. However, poor clinical outcomes were observed in all cases.
    RESULTS: Despite aggressive treatments, including chemotherapy and targeted therapies, poor clinical outcomes were observed, highlighting the aggressive nature of UTROSCT with significant rhabdoid differentiation.
    CONCLUSIONS: This case series emphasizes the importance of detailed pathological reporting, comprehensive molecular testing, and thorough tumor staging in UTROSCT cases with rhabdoid features. Enhanced understanding of the clinicopathologic characteristics of UTROSCT with rhabdoid differentiation is crucial for accurate diagnosis, prognostication, and management strategies.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    Objective: To investigate the clinicopathological features of children with metachronous or synchronous primary tumors and to identify related genetic tumor syndromes. Methods: The clinicopathological data of 4 children with multiple primary tumors diagnosed in the Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China from 2011 to 2023 were collected. The histological, immunophenotypic and molecular characteristics were examined using H&E staining, immunohistochemical staining, PCR, Sanger sequencing and next-generation sequencing (NGS). The patients were followed up. Results: Case 1 was an 8-year-old boy with the adrenal cortical carcinoma, and 5 years later a poorly differentiated gastric adenocarcinoma was detected. Case 2 was a 2-year-old boy, presented with a left ventricular choroid plexus carcinoma, and a hepatoblastoma was detected 8 months later. Case 3 was a 9-month-old girl, diagnosed with renal rhabdoid tumor first and intracranial atypical teratoid/rhabdoid tumor (AT/RT) 3 months later. Case 4 was a 7-year-old boy and had a sigmoid colon adenocarcinoma 3 years after the diagnosis of a glioblastoma. The morphology and immunohistochemical features of the metachronous or synchronous primary tumors in the 4 cases were similar to the corresponding symptom-presenting/first-diagnosed tumors. No characteristic germ line mutations were detected in cases 1 and 2 by relevant molecular detection, and the rhabdoid tumor predisposition syndrome was confirmed in case 3 using NGS. Case 4 was clearly related to constitutional mismatch repair deficiency as shown by the molecular testing and clinical features. Conclusions: Childhood multiple primary tumors are a rare disease with histological morphology and immunophenotype similar to the symptom-presenting tumors. They are either sporadic or associated with a genetic (tumor) syndrome. The development of both tumors can occur simultaneously (synchronously) or at different times (metachronously). Early identification of the children associated with genetic tumor syndromes can facilitate routine tumor screening and early treatment.
    目的: 探讨儿童多原发肿瘤的临床病理学特征及识别相关遗传肿瘤综合征。 方法: 收集上海交通大学医学院附属新华医院病理科2011—2023年诊断的4例儿童多原发肿瘤患者的临床病理资料,采用HE染色、免疫组织化学染色、PCR、Sanger测序及二代测序等方法观察组织学、免疫表型以及分子特征,并随访患者。 结果: 例1男,8岁,首发肾上腺皮质癌,5年后检出胃低分化腺癌;例2男,2岁,首发左侧侧脑室脉络丛癌,8个月后检出肝母细胞瘤;例3女,9个月,首发肾脏横纹肌样瘤,3个月后发现颅内非典型畸胎样/横纹肌样瘤;例4男,7岁,首发胶质母细胞瘤,3年后检出乙状结肠腺癌。4例患儿多原发肿瘤形态学及免疫组织化学均与相应的单发肿瘤相似,例1和例2经相关分子检测未检出特征性种系突变,例3经二代测序检测证实为横纹肌样瘤易感综合征,例4结合分子检测及临床特征明确与体质错配修复缺陷相关。 结论: 儿童多原发肿瘤是一类罕见的疾病,组织学形态和免疫表型与散发肿瘤相似,或散发,或与遗传肿瘤综合征相关。两种肿瘤可同时或异时发生,及早识别与遗传肿瘤综合征有关的患儿有助于实施定期肿瘤筛查并得到及时治疗。.
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  • 文章类型: Case Reports
    背景:恶性肾外横纹肌样瘤(MERT)是一种罕见且高度转移的肿瘤,超过75%的患者在初次诊断后6个月内死亡,经常导致误诊和延误治疗。
    方法:本文报道了一个主诉急性腹痛的16岁女孩。她接受了腹腔镜探查和切除活检,然后病理检查和免疫组化显示“肾外恶性横纹肌瘤”。“手术后一个月,她死于腹腔内出血和多器官功能障碍。
    结论:MERT常被误诊,预后不良。手术和化疗通常有利于延长MERT患者的生存时间。
    BACKGROUND: Malignant extrarenal rhabdoid tumor (MERT) is a rare and highly metastatic tumor, which is more than 75% of patients dying within 6 months of initial diagnosis, and it often leads to misdiagnosis and delayed treatment.
    METHODS: This paper reports a 16-year-old girl who presented with the chief complaint of acute abdominal pain. She underwent laparoscopic exploration and excisional biopsy, then pathological examination and immunohistochemistry revealed \"extrarenal malignant rhabdomyoma.\" One month after operation, she died of intra-abdominal hemorrhage and multiple organ dysfunction.
    CONCLUSIONS: MERT were often misdiagnosed and had a poor prognosis. The surgery and chemotherapy are usually beneficial to prolong the survival time of patients with MERT.
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  • 文章类型: Case Reports
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  • 文章类型: Journal Article
    椎管中的原发性非典型畸胎瘤/横纹肌样瘤(AT/RTs)是罕见的中枢神经系统(CNS)肿瘤,难以诊断和治疗。迄今为止,对于这些具有挑战性的恶性肿瘤,目前尚无标准治疗方案.因此,我们进行这项研究是为了探索改善这些肿瘤预后的潜在预后因素和可行的治疗方式.文章是从PubMed检索到的,Medline和EMBASE数据库,使用关键词“非典型畸胎瘤/横纹肌样瘤,横纹肌样瘤,\"\"脊柱,“\”脊柱,\"\"脊髓肿瘤\"和\"脊髓肿瘤。“所有符合条件的病例均显示SMARCB1缺陷表达,经病理检查证实。我们收集并分析了与临床表现相关的数据,放射学特征,病理特征,通过Kaplan-Meier和Cox回归分析治疗方式和预后。研究中纳入了36篇文章,其中包括58例脊柱AT/RT患者。中位无进展生存期(PFS)和总生存期(OS)分别为18个月和22个月。分别。Kaplan-Meier分析显示,非转移中OS的生存显著改善,男性,放疗和鞘内化疗组以及化疗和放疗组的PFS。多因素分析显示化疗和放疗是改善PFS的预后因素。鞘内化疗降低了死亡风险。脊髓AT/RT是罕见的恶性实体,生存率低。尽管我们的审查受到案例之间差异的限制,有一些证据揭示了潜在的危险因素和系统化疗的重要性,脊髓AT/RT治疗方式中的鞘内化疗和放疗。
    Primary atypical teratoid/rhabdoid tumors (AT/RTs) in the spinal canal are rare central nervous system (CNS) neoplasms that are challenging to diagnose and treat. To date, there has been no standard treatment regimen for these challenging malignant tumors. Thus, we conducted this research to explore potential prognostic factors and feasible treatment modalities for improving the prognosis of these tumors. Articles were retrieved from the PubMed, MEDLINE, and Embase databases, using the keywords \"atypical teratoid/rhabdoid tumor,\" \"rhabdoid tumor,\" \"spine,\" \"spinal,\" \"spinal neoplasm\", and \"spinal cord neoplasm.\" All eligible cases demonstrated SMARCB1-deficient expression validated by pathological examination. We collected and analyzed data related to clinical presentation, radiological features, pathological characteristics, treatment modalities and prognosis via Kaplan-Meier and Cox regression analyses. Thirty-six articles comprising 58 spinal AT/RT patients were included in the study. The median progression-free survival (PFS) and overall survival (OS) were 18 and 22 months, respectively. Kaplan-Meier analysis demonstrated significant survival improvements for OS in the nonmetastasis, male, radiotherapy and intrathecal chemotherapy groups as well as for PFS in the chemotherapy and radiotherapy groups. Multivariate analysis revealed that chemotherapy and radiotherapy were prognostic factors for improved PFS, and that intrathecal chemotherapy reduced the risk of mortality. Spinal AT/RTs are uncommon malignant entities with a dismal survival rate. Although our review is limited by variability between cases, there is some evidence revealing potential risk factors and the importance of systematic chemotherapy, intrathecal chemotherapy and radiotherapy in spinal AT/RT treatment modalities.
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  • 文章类型: Journal Article
    目的:确定肾脏恶性横纹肌样瘤(MRTK)的治疗靶点,并探讨盐酸多西环素对MRTK的作用及其机制。
    方法:从TARGET数据库检索MRTK的基因表达和临床数据。通过组合统计分析选择差异表达基因(DEGs)和预后相关基因(PRGs)。通过RNA过表达和干预实验阐明了MMP17和MMP1的功能作用。此外,体外和体内研究为盐酸多西环素对MRTK的抑制作用提供了证据。此外,转录组测序用于研究潜在的分子机制。
    结果:确定了MRTK中的3507个DEG和690个PRG。其中,我们集中研究了41个与不良预后相关的高表达基因,并揭示了它们参与细胞外基质调节通路.值得注意的是,MMP17和MMP1是特别有影响力的基因。当这些基因被敲除时,对增殖的显著抑制,在G401细胞中观察到侵袭和迁移。此外,我们的研究探讨了基质金属蛋白酶抑制剂的影响,盐酸多西环素,关于G401在体外和体内的恶性进展。结合测序数据,结果表明,盐酸多西环素可有效抑制MRTK的进展,由于其能够通过PI3K-Akt信号通路抑制MMP17和MMP1的表达。
    结论:盐酸多西环素通过PI3K-Akt信号通路抑制MMP17和MMP1的表达,从而在体内和体外抑制MRTK的恶性进展。
    OBJECTIVE: To identify therapeutic targets for malignant rhabdoid tumors of kidney (MRTK) and to investigate the effects and underlying mechanism of doxycycline hydrochloride on these tumors.
    METHODS: Gene expression and clinical data of MRTK were retrieved from the TARGET database. Differentially expressed genes (DEGs) and prognostic-related genes (PRGs) were selected through a combination of statistical analyses. The functional roles of MMP17 and MMP1 were elucidated through RNA overexpression and intervention experiments. Furthermore, in vitro and in vivo studies provided evidence for the inhibitory effect of doxycycline hydrochloride on MRTK. Additionally, transcriptome sequencing was employed to investigate the underlying molecular mechanisms.
    RESULTS: 3507 DEGs and 690 PRGs in MRTK were identified. Among these, we focused on 41 highly expressed genes associated with poor prognosis and revealed their involvement in extracellular matrix regulatory pathways. Notably, MMP17 and MMP1 stood out as particularly influential genes. When these genes were knocked out, a significant inhibition of proliferation, invasion and migration was observed in G401 cells. Furthermore, our study explored the impact of the matrix metalloproteinase inhibitor, doxycycline hydrochloride, on the malignant progression of G401 both in vitro and in vivo. Combined with sequencing data, the results indicated that doxycycline hydrochloride effectively inhibited MRTK progression, due to its ability to suppress the expression of MMP17 and MMP1 through the PI3K-Akt signaling pathway.
    CONCLUSIONS: Doxycycline hydrochloride inhibits the expression of MMP17 and MMP1 through the PI3K-Akt signaling pathway, thereby inhibiting the malignant progression of MRTK in vivo and in vitro.
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  • 文章类型: Meta-Analysis
    本文旨在探讨流行病学,临床特征,儿童颅外恶性横纹肌样瘤(eMRT)的预后。发表在PUBMED上的研究的系统评价和荟萃分析,MEDLINE,WebofScience,Embase,科克伦,和中国国家知识基础设施(CNKI)进行了研究。搜索仅限于1990年1月1日至2022年12月31日之间发表的研究,最后一次搜索是在2023年1月31日完成的。我们通过文献检索确定了496篇论文,纳入12项回顾性队列研究,共398例患者.诊断为肾脏恶性横纹肌样瘤(MRTK)的合并年龄为10.009个月(95CI(7.542-12.476)),而颅外恶性横纹肌样瘤(EERT)为25.917个月(95CI(17.304-34.530))。在398例eMRT患者中,化疗治疗率(86.8%(95CI(74.4-96.0%))高于放疗治疗率(45.4%(95CI(38.1-52.6%))).所有患者的转移率为41.4%(95CI(33.9-48.9%)),其中肺转移占70.4%(95CI(58.0-81.6%))。SMARCB1/INI1突变高达93.2%(95CI(81.3-99.8%))。手术总切除率为50.4%(95CI(35.2-65.6%)),而所有患者的合并死亡比例为68.7%(95CI(56.9~79.5%)).结论:EMRTs是高度恶性肿瘤,死亡率高。在绝大多数eMRT患者中观察到SMARCB1/INI1基因和蛋白质表达的丢失。MRTK患者比肾外EERT患者年轻,更容易发生肺转移,但是总体生存率没有显着差异,可能是由于MRTK原发肿瘤的R0切除率较高。试验注册:本研究在PROSPERO上注册,注册号为CRD42023400985。已知:•恶性横纹肌样瘤(MRT)是一种可能源自胚胎干细胞的罕见且高度恶性的肿瘤。捷运的发生率异常低,估计为0.00006%。•肾脏恶性横纹肌样瘤(MRTK)和肾外恶性横纹肌样瘤(EERT)往往在11至18个月大之间出现,5年生存率约为17%-36%。新增内容:•没有全面的荟萃分析或大规模病例系列报告系统地介绍eMRT临床结果和基于大量汇总数据的预测。本研究通过广泛的文献检索和临床数据分析进行了荟萃分析,以主要探讨eMRT的临床特征和预后。提高儿童对eMRT的理解。.
    This paper aims to explore the epidemiology, clinical characteristics, and prognosis of extracranial malignant rhabdoid tumors (eMRTs) in children. A systematic review and meta-analysis of studies published in PUBMED, MEDLINE, Web of Science, Embase, Cochrane, and China National Knowledge Infrastructure (CNKI) was conducted. The search was limited to studies published between Jan 1, 1990 to Dec 31, 2022, with the last search done on Jan 31, 2023. We identified 496 papers through the literature search, and 12 retrospective cohort studies with 398 patients were included. The pooled age at diagnosis for malignant rhabdoid tumor of the kidney (MRTK) was 10.009 months (95%CI (7.542-12.476)), while extracranial malignant rhabdoid tumor (EERT) was 25.917 months (95%CI (17.304-34.530)). Among the 398 patients with eMRTs, chemotherapy treatment rate (86.8% (95%CI (74.4-96.0%))) was more frequently than radiotherapy treatment (45.4% (95%CI (38.1-52.6%))). The rate of metastasis in all patients was 41.4% (95%CI (33.9-48.9%)), in which the lung metastasis was occupied 70.4% (95%CI (58.0-81.6%)). SMARCB1/INI1 mutation was up to 93.2% (95%CI (81.3-99.8%)). The rate of total surgical resection was 50.4% (95%CI (35.2-65.6%)), while pooled proportion of death in all patients was 68.7% (95%CI (56.9-79.5%)).     Conclusion: EMRTs are highly malignant tumors associated with high mortality rates. The loss of SMARCB1/INI1 gene and the protein expression is observed in the vast majority of eMRTs patients. Patients that suffered MRTK are younger than patients with extrarenal EERT and are more prone to lung metastasis, but there is no significant difference in overall survival, possibly due to the higher rate of R0 resection of primary tumors in MRTK.     Trial registration: The study was registered on PROSPERO with registration number CRD42023400985. What is Known: • Malignant rhabdoid tumor (MRT) is a rare and highly malignant tumor that may originate from embryonic stem cells. The incidence of MRT is exceptionally low, estimated at 0.00006%. • Malignant rhabdoid tumor of the kidney (MRTK) and extrarenal extra-cranial malignant rhabdoid tumor (EERT) tend to manifest between 11 to 18 months of age, with a 5-year survival rate of approximately 17%-36%. What is New: • There is no comprehensive meta-analysis or large-scale case series that reported to systematically introduce the eMRTs clinic outcome and prog-nosis based on largely pooled data. • This study performed a meta-analysis through an extensive literature search and clinical data analysis in order to mainly explore the clinical characteris-tics and prognosis of eMRTs, improving the understanding of eMRTs in children..
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  • 文章类型: Letter
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  • 文章类型: Review
    INI1缺陷型胃未分化癌是一种罕见的肿瘤,可能表现为高级上皮样形态,没有明显的横纹肌样肿瘤细胞。在这种情况下,合胞体肿瘤细胞可能是一个关键的线索,尤其是细胞学标本.细胞块和免疫细胞化学染色可以是实现准确诊断的有价值的工具。
    INI1-deficient gastric undifferentiated carcinoma is a rare tumour that may present as high-grade epithelioid morphology without apparent rhabdoid tumour cells. Syncytial tumour cells may be a crucial clue in such cases, especially in cytological specimens. Cell block and immunocytochemical staining can be valuable tools in achieving an accurate diagnosis.
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