Metachronous cardiac and cerebral sarcomas: case report with focus on molecular findings and review of the literature

Hum Pathol. 2015 Mar;46(3):482-7. doi: 10.1016/j.humpath.2014.10.028. Epub 2014 Dec 9.

Abstract

Although multiple primary malignancies are relatively rare, they have increased in frequency over the last decades, partly because of advances in diagnosis and therapy. This report describes for the first time the case of a patient with past occupational exposure to asbestos and no family history of cancer who developed 2 rare primary malignancies: a cardiac sarcoma and a gliosarcoma 11 months later. Molecular-cytogenetic studies did not identify common lesions to these 2 rare metachronous sarcomas. The gliosarcoma was associated with monosomy 10 and underlying PTEN monoallelic loss, which has been recurrently observed. In the cardiac sarcoma, MDM2 amplification and CDKN2AB/9p21 biallelic deletion suggested intimal sarcoma. No causal relationship was found between cardiac sarcoma and asbestos exposure, although MDM2 abnormalities were linked to malignant mesothelioma.

Keywords: Asbestos exposure; Cardiac sarcoma; Gliosarcoma; Multiple primary tumors; Synovial sarcoma.

Publication types

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

MeSH terms

  • 12E7 Antigen
  • Antigens, CD / analysis
  • Brain Neoplasms / chemistry
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / genetics
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / therapy
  • Cell Adhesion Molecules / analysis
  • Combined Modality Therapy
  • Fatal Outcome
  • Gliosarcoma / chemistry
  • Gliosarcoma / diagnosis
  • Gliosarcoma / genetics
  • Gliosarcoma / pathology*
  • Gliosarcoma / therapy
  • Heart Neoplasms / chemistry
  • Heart Neoplasms / diagnosis
  • Heart Neoplasms / genetics
  • Heart Neoplasms / pathology*
  • Heart Neoplasms / therapy
  • Humans
  • Immunohistochemistry
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasms, Second Primary / chemistry
  • Neoplasms, Second Primary / diagnosis
  • Neoplasms, Second Primary / pathology*
  • Neoplasms, Second Primary / therapy
  • Sarcoma / chemistry
  • Sarcoma / diagnosis
  • Sarcoma / genetics
  • Sarcoma / pathology*
  • Sarcoma / therapy
  • Vimentin / analysis

Substances

  • 12E7 Antigen
  • Antigens, CD
  • CD99 protein, human
  • Cell Adhesion Molecules
  • Vimentin

Supplementary concepts

  • Cerebral sarcoma