Unclassified low grade spindle cell sarcoma with storiform pattern characterized by recurrent novel EWSR1/FUS-NACC1 fusions Journal Article


Authors: Antonescu, C. R.; Dickson, B. C.; Zhang, L.; Sung, Y. S.; Fletcher, C. D.
Article Title: Unclassified low grade spindle cell sarcoma with storiform pattern characterized by recurrent novel EWSR1/FUS-NACC1 fusions
Abstract: Despite extraordinary advances in the molecular characterization of soft tissue tumors as a result of the widespread application of next generation sequencing in clinical practice, a subset of lesions remain difficult to diagnose. In this study we describe 3 unclassified spindle cell sarcomas with a monomorphic cytomorphology and distinctive storiform growth, characterized by novel fusions between EWSR1 or FUS1, and NACC1 genes. The tumors occurred in 3 young adult females (age range: 29–31) involving deep soft tissues, two located in the lower extremity and one in the abdominal wall. All three tumors showed patchy positivity for S100 protein, while being negative for SOX10 and retained H3K27me3 expression. All cases were negative for epithelial or muscle markers. As the findings were non-specific, molecular studies using targeted panels of RNA sequencing were performed, including one case tested by TruSight RNA Fusion Panel and 2 cases by Archer FusionPlex. The results showed 2 cases were positive for FUS-NACC1 and one for EWSR1-NACC1 fusions. These findings were further confirmed by FISH using custom BAC probes for a dual-color fusion assay. These results suggest the possibility of a previously undescribed soft tissue neoplasm characterized by a uniform spindle cell phenotype arranged in a storiform and fascicular pattern, expressing S100 protein and harboring NACC1-related fusions. The biologic behavior of this tumor remains to be determined. © 2021, The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.
Journal Title: Modern Pathology
Volume: 34
Issue: 8
ISSN: 0893-3952
Publisher: Nature Research  
Date Published: 2021-08-01
Start Page: 1541
End Page: 1546
Language: English
DOI: 10.1038/s41379-021-00805-x
PUBMED: 33859361
PROVIDER: scopus
PMCID: PMC8298288
DOI/URL:
Notes: Article -- Export Date: 1 September 2021 -- Source: Scopus
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  1. Cristina R Antonescu
    897 Antonescu
  2. Lei Zhang
    194 Zhang
  3. Yun Shao Sung
    124 Sung