title: FOXL2 molecular status in adult granulosa cell tumors of the ovary: A study of primary and metastatic cases.
abstract: Granulosa cell tumors (GCTs) of the ovary are uncommon neoplasms, accounting for ~5% of all malignant ovarian tumors. GCTs are a relatively homogeneous group of tumors, categorized into two distinct subtypes, juvenile GCT and adult GCT (AGCT), likely arising from a limited set of molecular events usually involving the disruption of pathways that regulate granulosa cell proliferation. In the present study, the presence of forkheadbox L2 (FOXL2) c.402C>G mutation was investigated in a series of 42 samples of primary and metastatic AGCT of the ovary. The samples consisted of 37 primary and 5 metastatic ovarian AGCTs from 37 patients. FOXL2 mutational status was evaluated using a pyrosequencing approach on 2.5-µm sections of formalin-fixed paraffin-embedded tissue. FOXL2 c.402C>G mutation was found in 33/37 (89.2%) primary AGCTs and in 4/5 (80.0%) metastases, with the molecular status of the metastases recapitulating that of the primary tumors (4 mutated cases and 1 wild-type case). Overall, FOXL2 mutation is present in the majority of primary and metastatic AGCTs, and could be used as a valid tool in the diagnosis of the disease and in cases of metastatic lesions from an unknown primary origin. Moreover the concordance of FOXL2 molecular status in primary and associated metastases suggests its early appearance and genomic stability in AGCT tumorigenesis.
authors.affiliation: Department of Pathology, Catholic University of The Sacred Heart, I-00168 Rome, Italy.
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Zannoni
authors.affiliation: Laboratory of Clinical Research and Advanced Diagnostics, Hospitalization and Treatment Institute Scientific-Oncological Referral Center of Basilicata, I-85028 Potenza, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Improta
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, I-00168 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Petrillo
authors.affiliation: Department of Pathology, Cannizzaro Hospital, I-95126 Catania, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Pettinato
authors.affiliation: Department of Obstetrics and Gynecology, Catholic University of the Sacred Heart, I-00168 Rome, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
authors.affiliation: Department of Pathology, Cannizzaro Hospital, I-95126 Catania, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Fraggetta
keywords: FOXL2; granulosa cell tumors; molecular signatures; mutation; ovary