Presacral malignant teratoid neoplasm in association with pathogenic DICER1 variation

Yoshiko Nakano, Daiichiro Hasegawa, Douglas R. Stewart, Kris Ann P. Schultz, Anne K. Harris, Junko Hirato, Suguru Uemura, Akihiro Tamura, Atsuro Saito, Atsufumi Kawamura, Makiko Yoshida, Kai Yamasaki, Satoshi Yamashita, Toshikazu Ushijima, Yoshiyuki Kosaka, Koichi Ichimura, Louis P. Dehner, D. Ashley Hill

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

We report two malignant sacrococcygeal tumors in infants that were associated with pathogenic DICER1 variation. These tumors were composed of primitive neuroepithelium, embryonal rhabdomyosarcoma, and cartilage and initially diagnosed as immature teratomas. One child developed intracranial metastasis and died. The second child underwent surgery and chemotherapy and achieved complete remission. This child subsequently developed five additional DICER1-associated neoplasms by age nine. Genetic analysis revealed that both tumors harbored biallelic pathogenic DICER1 variation. We believe these cases represent another novel subtype of DICER1-associated tumor. This new entity, which we propose to call DICER1-associated presacral malignant teratoid neoplasm, may be difficult initially to distinguish from immature teratoma, but recognizing it as an entity can prompt appropriate classification as an aggressive malignancy and facilitate appropriate genetic counseling, DICER1 germline variant testing, screening, and education.

Original languageEnglish
Pages (from-to)1744-1750
Number of pages7
JournalModern Pathology
Volume32
Issue number12
DOIs
StatePublished - Dec 1 2019

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