An unusual association of malignant gastrointestinal neuroectodermal tumor (clear cell sarcoma-like) and Ewing sarcoma

Pathol Res Pract. 2015 Sep;211(9):688-92. doi: 10.1016/j.prp.2015.06.001. Epub 2015 Jun 17.

Abstract

Very recently a new designation of "Malignant Neuroectodermal Gastrointestinal Tumor" has been proposed for an aggressive form of neuroectodermal tumor with features similar to that of Clear Cell Sarcoma of Soft Tissue, however without a melanocytic differentiation. Also known as "clear cell sarcoma-like tumors of the gastrointestinal tract", these tumors show some features strongly suggesting an origin from a gastrointestinal neuroectodermal precursor cell unable to differentiate along the melanocytic lineage. They occur mainly in young and middle-aged adults, and have a poor prognosis with a high rate of liver and lymphnode metastases. Histologically they are composed of epithelioid or oval-to spindle cells with a sheet-like or nested pattern of growth, strongly positive for neural markers (S-100, SOX10, and vimentin) and negative for the melanocytic ones. EWSR1 gene rearrangements including EWSR1-ATF1 or EWSR1-CREB1 GENE fusions are typically assessed in these tumors. Here we report a case of malignant neuroectodermal gastrointestinal tumor which immunophenotypically unusually expressed FLI-1, occurring in a 29-year-old man with a previous medical history of Ewing sarcoma. We finally suggest that this case might be a further evidence of a link between these two entities.

Keywords: Clear cell sarcoma-like gastric tumor.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / analysis
  • Biopsy
  • Bone Neoplasms / chemistry
  • Bone Neoplasms / pathology*
  • Chemotherapy, Adjuvant
  • Gastrectomy
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Magnetic Resonance Imaging
  • Male
  • Neoplasms, Second Primary / chemistry
  • Neoplasms, Second Primary / genetics
  • Neoplasms, Second Primary / pathology*
  • Neoplasms, Second Primary / therapy
  • Neuroectodermal Tumors, Primitive / chemistry
  • Neuroectodermal Tumors, Primitive / genetics
  • Neuroectodermal Tumors, Primitive / pathology*
  • Neuroectodermal Tumors, Primitive / therapy
  • Polymerase Chain Reaction
  • Sarcoma, Clear Cell / chemistry
  • Sarcoma, Clear Cell / genetics
  • Sarcoma, Clear Cell / pathology*
  • Sarcoma, Clear Cell / therapy
  • Sarcoma, Ewing / chemistry
  • Sarcoma, Ewing / pathology*
  • Stomach Neoplasms / chemistry
  • Stomach Neoplasms / genetics
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / therapy
  • Treatment Outcome

Substances

  • Biomarkers, Tumor