1. Alterations in key signaling pathways in sinonasal tract melanoma. A molecular genetics and immunohistochemical study of 90 cases and comprehensive review of the literature
- Author
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Małgorzata Chłopek, Jerzy Lasota, Lester D.R. Thompson, Magdalena Szczepaniak, Alina Kuźniacka, Kinga Hińcza, Kamila Kubicka, Maciej Kaczorowski, Michael Newford, Yalan Liu, Abbas Agaimy, Wojciech Biernat, Monika Durzyńska, Ireneusz Dziuba, Arndt Hartmann, Shingo Inaguma, Ewa Iżycka-Świeszewska, Hiroyuki Kato, Janusz Kopczyński, Michal Michal, Michael Michal, Rafał Pęksa, Monika Prochorec-Sobieszek, Anna Starzyńska, Satoru Takahashi, Bartosz Wasąg, Artur Kowalik, and Markku Miettinen
- Subjects
Male ,Proto-Oncogene Proteins B-raf ,Class I Phosphatidylinositol 3-Kinases ,TOR Serine-Threonine Kinases ,DNA Mutational Analysis ,Pathology and Forensic Medicine ,Mutation ,Paranasal Sinuses ,Humans ,RNA ,Female ,Melanoma ,Molecular Biology ,In Situ Hybridization, Fluorescence ,Paranasal Sinus Neoplasms ,Aged ,Signal Transduction - Abstract
Sinonasal mucosal melanoma is a rare tumor arising within the nasal cavity, paranasal sinuses, or nasopharynx (sinonasal tract). This study evaluated 90 cases diagnosed in 29 males and 61 females with median age 68 years. Most tumors involved the nasal cavity and had an epithelioid morphology. Spectrum of research techniques used in this analysis includes targeted-DNA and -RNA next-generation sequencing, Sanger sequencing, fluorescence in situ hybridization and immunohistochemistry. Sinonasal melanomas were commonly driven by RAS (38/90, 42%), especially NRAS (n = 36) mutations and rarely (4/90, 4%) displayed BRAF pathogenic variants. BRAF/RAS mutants were more frequent among paranasal sinuses (10/14, 71%) than nasal (26/64, 41%) tumors. BRAF/RAS-wild type tumors occasionally harbored alterations of the key components and regulators of Ras-MAPK signaling pathway: NF1 mutations (1/17, 6%) or NF1 locus deletions (1/25, 4%), SPRED1 (3/25, 12%), PIK3CA (3/50, 6%), PTEN (4/50, 8%) and mTOR (1/50, 2%) mutations. These mutations often occurred in a mutually exclusive manner. In several tumors some of which were NRAS mutants, TP53 was deleted (6/48, 13%) and/or mutated (5/90, 6%). Variable nuclear accumulation of TP53, mirrored by elevated nuclear MDM2 expression was seen in50% of cases. Furthermore, sinonasal melanomas (n = 7) including RAS/BRAF-wild type tumors (n = 5) harbored alterations of the key components and regulators of canonical WNT-pathway: APC (4/90, 4%), CTNNB1 (3/90, 3%) and AMER1 (1/90, 1%). Both, TERT promoter mutations (5/53, 9%) and fusions (2/40, 5%) were identified. The latter occurred in BRAF/RAS-wild type tumors. No oncogenic fusion gene transcripts previously reported in cutaneous melanomas were detected. Eight tumors including 7 BRAF/RAS-wild type cases expressed ADCK4::NUMBL cis-fusion transcripts. In summary, this study documented mutational activation of NRAS and other key components and regulators of Ras-MAPK signaling pathway such as SPRED1 in a majority of sinonasal melanomas.
- Published
- 2022