Adult Wilms tumor: Genetic evidence of origin of a subset of cases from metanephric adenoma Journal Article


Authors: Argani, P.; Tickoo, S. K.; Matoso, A.; Pratilas, C. A.; Mehra, R.; Tretiakova, M.; Sibony, M.; Meeker, A. K.; Lin, M. T.; Reuter, V. E.; Epstein, J. I.; Gagan, J.; Palsgrove, D. N.
Article Title: Adult Wilms tumor: Genetic evidence of origin of a subset of cases from metanephric adenoma
Abstract: The genetics of nephroblastoma (Wilms tumor) occurring in adults is largely unknown, as studies have largely been limited to isolated case reports. We, therefore, studied 14 adult Wilms tumors for genetic alterations, using expanded targeted sequencing on 11 cases. The patients ranged from 17 to 46 years of age (mean and median, 31 y), and there were 8 males and 6 females. Five Wilms tumors harbored BRAF V600E mutations. All of these had better-differentiated areas identical to metanephric adenoma, as has previously been described. In 3 such cases, microdissection studies revealed that the BRAF V600E mutation was present in both the metanephric adenoma and Wilms tumor areas; however, additional genetic alterations (including TERT promoter mutations in 2 cases, ASLX1/ATR mutations in 1 other case) were limited to the Wilms tumor component. These findings suggest that the Wilms tumor developed from the metanephric adenoma. Other adult Wilms tumors harbored genetic alterations previously reported in the more common pediatric Wilms tumors, including WT1 mutations (2 cases), ASLX1 mutations (3 additional cases), NSD2 mutation (1 additional case), and 11p loss (3 cases). In summary, a significant subset of adult Wilms tumors (specifically those of epithelial type with differentiated areas) harbor targetable BRAF V600E mutations and appear to arise from metanephric adenomas as a consequence of additional acquired genetic alterations. Other adult Wilms tumors often harbor genetic alterations found in their more common pediatric counterparts, suggesting at least some similarities in their pathogenesis. © 2022 Lippincott Williams and Wilkins. All rights reserved.
Keywords: braf; renal neoplasm; wilms; metanephric
Journal Title: American Journal of Surgical Pathology
Volume: 46
Issue: 7
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2022-07-01
Start Page: 988
End Page: 999
Language: English
DOI: 10.1097/pas.0000000000001864
PUBMED: 35184066
PROVIDER: scopus
PMCID: PMC9310085
DOI/URL:
Notes: Article -- Export Date: 1 July 2022 -- Source: Scopus
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  1. Satish K Tickoo
    478 Tickoo
  2. Victor Reuter
    1223 Reuter