EWSR1-ATF1 Fusion in a Myoepithelial Carcinoma of Soft Tissue With Small Round Cell Morphology: A Potential Diagnostic Pitfall

Pediatr Dev Pathol. 2021 May-Jun;24(3):258-263. doi: 10.1177/1093526621998869. Epub 2021 Mar 8.

Abstract

Myoepithelial tumors of soft tissue are rare mesenchymal neoplasms that overlap with their salivary gland and skin counterparts at both the histopathologic and molecular levels. EWSR1 gene rearrangements with various fusion partners represent a common genetic event in myoepithelial tumors of soft tissue, whether benign or malignant, and may prove useful as a diagnostic tool in difficult cases. However, the number of diagnostic entities with EWSR1 gene rearrangements has grown considerably in recent years, and there is significant morphologic and immunophenotypic overlap amongst this group, underscoring the importance of fusion testing to detect fusion partners that are characteristic of discrete diagnostic entities. Herein, we report a malignant myoepithelial tumor of soft tissue/myoepithelial carcinoma with an undifferentiated round cell morphology arising in a pediatric patient with a EWSR1-ATF1 gene fusion.

Keywords: EWSR1; EWSR1-ATF1; fusion; myoepithelial carcinoma; round cell; undifferentiated.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Biomarkers, Tumor / genetics
  • Carcinoma, Small Cell / diagnosis
  • Carcinoma, Small Cell / genetics*
  • Carcinoma, Small Cell / pathology
  • Diagnosis, Differential
  • Humans
  • Male
  • Myoepithelioma / diagnosis
  • Myoepithelioma / genetics*
  • Myoepithelioma / pathology
  • Oncogene Proteins, Fusion / genetics*
  • Sarcoma / diagnosis
  • Soft Tissue Neoplasms / diagnosis
  • Soft Tissue Neoplasms / genetics*
  • Soft Tissue Neoplasms / pathology

Substances

  • Biomarkers, Tumor
  • EWSR1-ATF1 fusion protein, human
  • Oncogene Proteins, Fusion