title: Novel YAP1-TFE3 fusion defines a distinct subset of epithelioid hemangioendothelioma.
abstract: Conventional epithelioid hemangioendotheliomas (EHE) have a distinctive morphologic appearance and are characterized by a recurrent t(1;3) translocation, resulting in a WWTR1-CAMTA1 fusion gene. We have recently encountered a fusion-negative subset characterized by a somewhat different morphology, including focally well-formed vasoformative features, which was further investigated for recurrent genetic abnormalities. Based on a case showing strong transcription factor E3 (TFE3) immunoreactivity, fluorescence in situ hybridization (FISH) analysis for TFE3 gene rearrangement was applied to the index case as well as to nine additional cases, selected through negative WWTR1-CAMTA1 screening. A control group, including 18 epithelioid hemangiomas, nine pseudomyogenic HE, and three epithelioid angiosarcomas, was also tested. TFE3 gene rearrangement was identified in 10 patients, with equal gender distribution and a mean age of 30 years old. The lesions were located in somatic soft tissue in six cases, lung in three and one in bone. One case with available frozen tissue was tested by RNA sequencing and FusionSeq data analysis to detect novel fusions. A YAP1-TFE3 fusion was thus detected, which was further validated by FISH and reverse transcription polymerase chain reaction (RT-PCR). YAP1 gene rearrangements were then confirmed in seven of the remaining nine TFE3-rearranged EHEs by FISH. No TFE3 structural abnormalities were detected in any of the controls. The TFE3-rearranged EHEs showed similar morphologic features with at least focally, well-formed vascular channels, in addition to a variably solid architecture. All tumors expressed endothelial markers, as well as strong nuclear TFE3. In summary, we are reporting a novel subset of EHE occurring in young adults, showing a distinct phenotype and YAP1-TFE3 fusions.
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA. antonesc@mskcc.org
authors.forename: Cristina R
authors.initials: CR
authors.lastname: Antonescu
authors.forename: Francois
authors.initials: F
authors.lastname: Le Loarer
authors.forename: Juan-Miguel
authors.initials: JM
authors.lastname: Mosquera
authors.forename: Andrea
authors.initials: A
authors.lastname: Sboner
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Chun-Liang
authors.initials: CL
authors.lastname: Chen
authors.forename: Hsiao-Wei
authors.initials: HW
authors.lastname: Chen
authors.forename: Nursat
authors.initials: N
authors.lastname: Pathan
authors.forename: Thomas
authors.initials: T
authors.lastname: Krausz
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Dickson
authors.forename: Ilan
authors.initials: I
authors.lastname: Weinreb
authors.forename: Mark A
authors.initials: MA
authors.lastname: Rubin
authors.forename: Meera
authors.initials: M
authors.lastname: Hameed
authors.forename: Christopher D M
authors.initials: CD
authors.lastname: Fletcher
mesh_terms: D048868:Adaptor Proteins, Signal Transducing / Q000235:genetics*; D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors / Q000235:genetics*; D005260:Female; D015321:Gene Rearrangement / Q000235:genetics; D018323:Hemangioendothelioma, Epithelioid / Q000175:diagnosis / Q000235:genetics* / Q000473:pathology; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D007680:Kidney Neoplasms / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015514:Oncogene Proteins, Fusion / Q000235:genetics* / Q000302:isolation & purification; D010750:Phosphoproteins / Q000235:genetics*; D017423:Sequence Analysis, RNA; D014157:Transcription Factors; D014178:Translocation, Genetic / Q000235:genetics; D000091102:YAP-Signaling Proteins
chemical_list: D048868:Adaptor Proteins, Signal Transducing; D051778:Basic Helix-Loop-Helix Leucine Zipper Transcription Factors; D015514:Oncogene Proteins, Fusion; D010750:Phosphoproteins; C069203:TFE3 protein, human; D014157:Transcription Factors; D000091102:YAP-Signaling Proteins; C088374:YAP1 protein, human