Primary pulmonary myxoid sarcoma withEWSR1-CREB1fusion, resembling extraskeletal myxoid chondrosarcoma: Case report with a review of Literature

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Abstract

Reported herein is an extremely rare case of primary pulmonary myxoid sarcoma (PPMS). A 31-year-old man presented with a 2.7 cm-sized pulmonary tumor surrounded by capsule-like fibrosis. The patient has been free of disease for 5.8 years after surgery. This tumor focally showed endobronchial features, and consisted of reticular cords of oval, short spindle, or polygonal cells with swollen vesicular nuclei accompanied by an abundant myxoid stroma, closely resembling extraskeletal myxoid chondrosarcoma. Tumor cells were diffusely positive for vimentin and focally positive for epithelial membrane antigen, but were negative for cytokeratin, TTF-1, Napsin A, S-100 protein, CD34, desmin, smooth-muscle actin, CD10, p63, calponin, h-caldesmon, c-kit, HMB-45, synaptophysin, or glial fibrillary acid protein. Our reverse transcription-polymerase chain reaction using the formalin-fixed, paraffin-embedded tumor tissues detectedEWSR1-CREB1fusion transcript, but could not demonstrateEWSR1-ATF1fusion orEWSR1/TAF15/TFG-NR4A3fusion. These findings indicate that the current tumor is an additional case of PPMS withEESR1-CREB1fusion, recently reported by Thwayet al. Some cases of PPMS can behave in an indolent manner.

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