Novel SS18-NEDD4 gene fusion in a primary renal synovial sarcoma Journal Article


Authors: Argani, P.; Zhang, L.; Sung, Y. S.; Bacchi, C.; Swanson, D.; Dickson, B. C.; Antonescu, C. R.
Article Title: Novel SS18-NEDD4 gene fusion in a primary renal synovial sarcoma
Abstract: We report a primary renal synovial sarcoma with a novel gene fusion and unusual morphology. The patient was a 35-year-old female who was found to have a 5 cm hypocellular, myxoid spindle cell renal neoplasm that subtly permeated amongst native renal tubules. The tumor cells showed elongated hyperchromatic nuclei with ill-defined pale cytoplasm, lacking significant mitotic activity or necrosis. Based on its deceptively bland morphology, the differential diagnosis included mainly benign entities, such as metanephric stromal tumor, mixed epithelial stromal tumor (MEST), and myxoid peripheral nerve sheath tumors. A definitive diagnosis of synovial sarcoma was made only subsequently to RNA-sequencing, which revealed a novel SS18-NEDD4 gene fusion. These results were further confirmed by fluorescence in situ hybridization using custom design break-apart probes for both genes. This case illustrates the utility of targeted RNA-sequencing in the classification of challenging tumors with deceptive morphology and identification of novel gene fusion variants. Apart from the canonical SS18-SSX fusion, this is only the second alternative gene fusion variant described in synovial sarcoma to date, in addition to two cases harboring the SS18L1-SSX1 fusion. © 2019 Wiley Periodicals, Inc.
Keywords: immunohistochemistry; adult; clinical article; human tissue; case report; gene; tumor volume; differential diagnosis; fluorescence in situ hybridization; radical nephrectomy; gene fusion; synovial sarcoma; rna sequence; chromosome 15q; renal; kidney sarcoma; human; female; priority journal; article; ss18 gene; ss18, nedd4, fusion; nedd4 gene; primary renal synovial sarcoma
Journal Title: Genes Chromosomes and Cancer
Volume: 59
Issue: 3
ISSN: 1045-2257
Publisher: Wiley Periodicals, Inc  
Date Published: 2020-03-01
Start Page: 203
End Page: 208
Language: English
DOI: 10.1002/gcc.22814
PUBMED: 31595587
PROVIDER: scopus
PMCID: PMC7086378
DOI/URL:
Notes: Article -- Export Date: 3 February 2020 -- Source: Scopus
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  1. Cristina R Antonescu
    898 Antonescu
  2. Lei Zhang
    194 Zhang
  3. Yun Shao Sung
    124 Sung