A case of dedifferentiated solitary fibrous tumor in the pelvis with TP53 mutation

Virchows Arch. 2014 Nov;465(5):615-21. doi: 10.1007/s00428-014-1625-3.

Abstract

Solitary fibrous tumors (SFTs), initially observed in the pleura, were later found to develop in almost any extrapleural site. Dedifferentiation within SFTs was characterized only recently. We report a case of dedifferentiated SFT arising within the pelvis of a 70-year-old Japanese woman. Macroscopically, the resected tumor measured 17 × 17 × 13 cm. Histologically, the tumor displayed distinct heterologous osteosarcomatous and chondrosarcomatous components on a background of conventional SFT. Immunohistochemistry uncovered a loss of CD34 expression in the dedifferentiated area, whereas the nuclear expression of signal transducer and activator of transcription-6 (STAT6) and NGFI-A-binding protein 2 (NAB2) was maintained in both components. The p53 mutation 158 CGC > CAC (A158H) was found only in the dedifferentiated component. Furthermore, a fusion gene of NAB2(exon6)-STAT6(exon18) was detected in both the conventional and dedifferentiated components. The patient died of the disease 4 months after surgery. This case identifies a possible role of p53 dysfunction in the dedifferentiation process of SFT as reported in other sarcomas.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cell Dedifferentiation*
  • Female
  • Genes, p53 / genetics*
  • Humans
  • Mutation
  • Oncogene Proteins, Fusion / metabolism
  • Pelvis
  • Solitary Fibrous Tumors / genetics*
  • Solitary Fibrous Tumors / pathology*

Substances

  • Oncogene Proteins, Fusion