@article{2362c7f7136e4d6f97f64220781ae6ce,
title = "Intracranial mesenchymal tumors with FET-CREB fusion are composed of at least two epigenetic subgroups distinct from meningioma and extracranial sarcomas",
abstract = "{\textquoteleft}Intracranial mesenchymal tumor, FET-CREB fusion-positive{\textquoteright} occurs primarily in children and young adults and has previously been termed intracranial angiomatoid fibrous histiocytoma (AFH) or intracranial myxoid mesenchymal tumor (IMMT). Here we performed genome-wide DNA methylation array profiling of 20 primary intracranial mesenchymal tumors with FET-CREB fusion to further study their ontology. These tumors resolved into two distinct epigenetic subgroups that were both divergent from all other analyzed intracranial neoplasms and soft tissue sarcomas, including meningioma, clear cell sarcoma of soft tissue (CCS), and AFH of extracranial soft tissue. The first subgroup (Group A, 16 tumors) clustered nearest to but independent of solitary fibrous tumor and AFH of extracranial soft tissue, whereas the second epigenetic subgroup (Group B, 4 tumors) clustered nearest to but independent of CCS and also lacked expression of melanocytic markers (HMB45, Melan A, or MITF) characteristic of CCS. Group A tumors most often occurred in adolescence or early adulthood, arose throughout the neuroaxis, and contained mostly EWSR1-ATF1 and EWSR1-CREB1 fusions. Group B tumors arose most often in early childhood, were located along the cerebral convexities or spinal cord, and demonstrated an enrichment for tumors with CREM as the fusion partner (either EWSR1-CREM or FUS-CREM). Group A tumors more often demonstrated stellate/spindle cell morphology and hemangioma-like vasculature, whereas Group B tumors more often demonstrated round cell or epithelioid/rhabdoid morphology without hemangioma-like vasculature, although robust comparison of these clinical and histologic features requires future study. Patients with Group B tumors had inferior progression-free survival relative to Group A tumors (median 4.5 vs. 49 months, p = 0.001). Together, these findings confirm that intracranial AFH-like neoplasms and IMMT represent histologic variants of a single tumor type ({\textquoteleft}intracranial mesenchymal tumor, FET-CREB fusion-positive{\textquoteright}) that is distinct from meningioma and extracranial sarcomas. Additionally, epigenomic evaluation may provide important prognostic subtyping for this unique tumor entity.",
keywords = "ATF1, CREB1, CREM, EWSR1, angiomatoid fibrous histiocytoma (AFH), brain tumor, clear cell sarcoma, intracranial mesenchymal tumor with FET-CREB fusion, intracranial myxoid mesenchymal tumor, molecular neuropathology, sarcoma",
author = "Sloan, {Emily A.} and Rohit Gupta and Christian Koelsche and Jason Chiang and Villanueva-Meyer, {Javier E.} and Sanda Alexandrescu and Eschbacher, {Jennifer M.} and Wesley Wang and Manuela Mafra and {Ud Din}, Nasir and Emily Carr-Boyd and Michael Watson and Michael Punsoni and Angelica Oviedo and Ahmed Gilani and Kleinschmidt-DeMasters, {Bette K.} and Coss, {Dylan J.} and Lopes, {M. Beatriz} and Alyssa Reddy and Sabine Mueller and Cho, {Soo Jin} and Horvai, {Andrew E.} and Lee, {Julieann C.} and Melike Pekmezci and Tarik Tihan and Bollen, {Andrew W.} and Rodriguez, {Fausto J.} and Ellison, {David W.} and Arie Perry and {von Deimling}, Andreas and Chang, {Susan M.} and Berger, {Mitchel S.} and Solomon, {David A.}",
note = "Funding Information: We thank Hong Quach and the staff of the QB3 Functional Genomics Laboratory at the University of California, Berkeley for assistance with DNA methylation array hybridization and scanning. This study was supported by the NIH Director{\textquoteright}s Early Independence Award from the Office of the Director, National Institutes of Health (DP5 OD021403) to D.A.S.; a Developmental Research Program Award from the UCSF Brain Tumor SPORE from the National Cancer Institute, National Institutes of Health (P50 CA097257) to D.A.S.; a generous donation from the Morgan Adams Foundation funding kids{\textquoteright} cancer research to D.A.S., a generous donation from the Yuvaan Tiwari Foundation supporting pediatric brain tumor research to D.A.S., and the UCSF Glioblastoma Precision Medicine Program sponsored by the Sandler Foundation. Funding Information: We thank Hong Quach and the staff of the QB3 Functional Genomics Laboratory at the University of California, Berkeley for assistance with DNA methylation array hybridization and scanning. This study was supported by the NIH Director{\textquoteright}s Early Independence Award from the Office of the Director, National Institutes of Health (DP5 OD021403) to D.A.S.; a Developmental Research Program Award from the UCSF Brain Tumor SPORE from the National Cancer Institute, National Institutes of Health (P50 CA097257) to D.A.S.; a generous donation from the Morgan Adams Foundation funding kids{\textquoteright} cancer research to D.A.S., a generous donation from the Yuvaan Tiwari Foundation supporting pediatric brain tumor research to D.A.S., and the UCSF Glioblastoma Precision Medicine Program sponsored by the Sandler Foundation. Publisher Copyright: {\textcopyright} 2021 The Authors. Brain Pathology published by John Wiley & Sons Ltd on behalf of International Society of Neuropathology.",
year = "2022",
month = jul,
doi = "10.1111/bpa.13037",
language = "English (US)",
volume = "32",
journal = "Brain Pathology",
issn = "1015-6305",
publisher = "Wiley-Blackwell",
number = "4",
}