title: Biphenotypic sarcomas with myogenic and neural differentiation express the Ewing's sarcoma EWS/FLI1 fusion gene.
abstract: Accurate diagnosis of primitive childhood sarcomas continues to be a formidable problem because these malignancies generally demonstrate very little morphological evidence of their tissue of origin. One of these tumor classes, the Ewing's sarcoma family of peripheral primitive neuroectodermal tumors (pPNETs), are thought to have a neural histogenesis based on evidence of neuroectodermal differentiation. Greater than 95% of pPNETs carry t(11;22) or t(21;22) chromosomal translocations which fuse the EWS gene from chromosome 22q12 in-frame with either FLI1 from chromosome 11q24 or ERG from chromosome 21q22. The pPNETs are considered to be histogenetically distinct from rhabdomyosarcomas, myogenic tumors lacking these EWS gene fusions and hypothesized to derive from immature skeletal muscle precursors. In the present study, we describe a unique set of childhood soft tissue sarcomas that show both neural and myogenic differentiation. These biphenotypic tumors express myogenic regulatory factors and muscle-specific antigens and also show neuroectodermal differentiation with ultrastructural evidence of neurosecretory granules and expression of neural-associated genes. Northern analysis and reverse transcriptase PCR reveal expression of EWS/FLI1 gene fusions in all biphenotypic sarcomas analyzed. Chimeric EWS/FLI1 transcripts and fusion proteins in these tumors are identical to those described for pPNETs. Our results provide evidence for a class of biphenotypic childhood sarcomas with myogenic and neural differentiation and suggest that these tumors may be related to the Ewing's sarcoma family of pPNETs.
authors.affiliation: Department of Pathology and Laboratory Medicine, British Columbia's Children's Hospital/University of British Columbia, Vancouver, Canada.
authors.forename: P H
authors.initials: PH
authors.lastname: Sorensen
authors.forename: H
authors.initials: H
authors.lastname: Shimada
authors.forename: X F
authors.initials: XF
authors.lastname: Liu
authors.forename: J F
authors.initials: JF
authors.lastname: Lim
authors.forename: G
authors.initials: G
authors.lastname: Thomas
authors.forename: T J
authors.initials: TJ
authors.lastname: Triche
mesh_terms: D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D002454:Cell Differentiation; D002648:Child; D004268:DNA-Binding Proteins / Q000235:genetics*; D015870:Gene Expression; D034441:Heterogeneous-Nuclear Ribonucleoproteins; D006801:Humans; D007223:Infant; D008969:Molecular Sequence Data; D017570:MyoD Protein / Q000235:genetics; D018242:Neuroectodermal Tumors, Primitive / Q000235:genetics / Q000473:pathology*; D009687:Nuclear Proteins / Q000235:genetics*; D010641:Phenotype; D051789:Proto-Oncogene Protein c-fli-1; D011518:Proto-Oncogene Proteins; D034802:RNA-Binding Protein EWS; D016601:RNA-Binding Proteins / Q000235:genetics*; D011993:Recombinant Fusion Proteins / Q000235:genetics*; D012261:Ribonucleoproteins / Q000235:genetics*; D012512:Sarcoma, Ewing / Q000235:genetics / Q000473:pathology*; D015534:Trans-Activators / Q000235:genetics*; D014407:Tumor Cells, Cultured
chemical_list: D004268:DNA-Binding Proteins; D034441:Heterogeneous-Nuclear Ribonucleoproteins; D017570:MyoD Protein; C057363:MyoD1 myogenic differentiation protein; D009687:Nuclear Proteins; D051789:Proto-Oncogene Protein c-fli-1; D011518:Proto-Oncogene Proteins; D034802:RNA-Binding Protein EWS; D016601:RNA-Binding Proteins; D011993:Recombinant Fusion Proteins; D012261:Ribonucleoproteins; D015534:Trans-Activators