Epithelioid and spindle cell rhabdomyosarcoma with EWSR1::TFCP2 fusion mimicking metastatic lung cancer: A case report and literature review

Pathol Res Pract. 2023 Sep:249:154779. doi: 10.1016/j.prp.2023.154779. Epub 2023 Aug 22.

Abstract

Rhabdomyosarcoma (RMS) with EWSR1/FUS::TFCP2 fusion is an emerging, molecularly defined, rare subtype of RMS. It can affect patients in a wide age range and follows an aggressive clinical course according to the reported cases. Due to its unusual clinical and pathohistological features, with a typical intraosseous presentation and common cytokeratin expression, the diagnosis is challenging, and metastatic undifferentiated/sarcomatoid carcinoma can be an important differential diagnosis. We report here a case of a 55-year-old woman with an RMS with EWSR1::TFCP2 fusion mimicking metastatic lung cancer in view of the clinical and microscopic presentation. However, further molecular workup, including RNA sequencing, led to the proper diagnosis. Although these tumors are rare, knowledge of their unique features is essential for correct diagnosis as a basis for clinical management and optimization of therapeutic approaches.

Keywords: ALK; Cytokeratin expression; Intraosseous rhabdomyosarcoma; RNA- Sequencing; TFCP2 rearrangement.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Adult
  • Carcinoma*
  • Child
  • DNA-Binding Proteins
  • Diagnosis, Differential
  • Female
  • Humans
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / genetics
  • Middle Aged
  • RNA-Binding Protein EWS / genetics
  • Rhabdomyosarcoma*
  • Rhabdomyosarcoma, Embryonal*
  • Transcription Factors / genetics

Substances

  • Transcription Factors
  • EWSR1 protein, human
  • RNA-Binding Protein EWS
  • TFCP2 protein, human
  • DNA-Binding Proteins