Uterine tumor resembling ovarian sex cord tumor: A distinct entity characterized by recurrent NCOA2/3 gene fusions Review


Authors: Dickson, B. C.; Childs, T. J.; Colgan, T. J.; Sung, Y. S.; Swanson, D.; Zhang, L.; Antonescu, C. R.
Review Title: Uterine tumor resembling ovarian sex cord tumor: A distinct entity characterized by recurrent NCOA2/3 gene fusions
Abstract: Uterine tumor resembling ovarian sex-cord tumor (UTROSCT) is a rare and distinctive neoplasm of unclear histogenesis, and uncertain malignant potential. These neoplasms morphologically resemble sex-cord stromal tumors of the ovary, and possess a polyphenotypic immunophenotype. Their molecular pathogenesis has yet to be elucidated; notably, however, tumors lack alterations found in other uterine tumors bearing sex-cord-like differentiation, such as endometrial stromal sarcoma. Following identification of an index patient with an ESR1-NCOA3 fusion gene by RNA-sequencing, we undertook a retrospective review for additional cases of UTROSCT. We identified a total of 4 patients, with an average age of 53 years (range, 38 to 68 y). RNA-sequencing was performed in all cases, revealing an ESR1-NCOA3 fusion in 2 cases and one case each with related ESR1-NCOA2 and GREB1-NCOA2 fusions. Each of the tumors showed histologic and an immunophenotype features within the previously reported spectrum of UTROSCT; interestingly, one case contained prominent spindle cell fascicles and another was largely comprised of sheets of small round cells. Our results demonstrate UTROSCT are defined by recurrent fusions involving NCOA2 or NCOA3, a finding that is directly amenable to diagnostic evaluation. This study confirms UTROSCT is molecularly distinct from endometrial stromal sarcoma, and raises intriguing new questions into the pathogenesis of these neoplasms and possible relationship with other NCOA fusion-positive uterine tumors. Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: uterus; ncoa2; esr1; greb1; ncoa3; sex cord; uterine tumor resembling ovarian sex-cord tumor
Journal Title: American Journal of Surgical Pathology
Volume: 43
Issue: 2
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-02-01
Start Page: 178
End Page: 186
Language: English
DOI: 10.1097/pas.0000000000001153
PUBMED: 30273195
PROVIDER: scopus
PMCID: PMC6719705
DOI/URL:
Notes: Article -- Export Date: 1 March 2019 -- Source: Scopus
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  1. Cristina R Antonescu
    895 Antonescu
  2. Lei Zhang
    194 Zhang
  3. Yun Shao Sung
    124 Sung