Format

Send to

Choose Destination
Mol Cancer Res. 2018 Oct;16(10):1491-1498. doi: 10.1158/1541-7786.MCR-17-0507. Epub 2018 Jul 13.

Desmoplastic Infantile Ganglioglioma/Astrocytoma (DIG/DIA) Are Distinct Entities with Frequent BRAFV600 Mutations.

Author information

1
Department of Neurosurgery, University of California Los Angeles, Los Angeles, California.
2
Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ), Heidelberg University, Heidelberg, Germany.
3
Department of Neurological Surgery, University of Washington and Seattle Children's Hospital, Seattle, Washington.
4
Department of Anatomic Pathology, University of Washington and Seattle Children's Hospital, Seattle, Washington.
5
Department of Pediatrics, Division of Hematology/Oncology, University of Washington and Seattle Children's Hospital, Seattle, Washington.
6
Department of Laboratory Medicine, University of Washington and Seattle Children's Hospital, Seattle, Washington.
7
Department of Neuropathology, German Cancer Research Center (DKFZ), Heidelberg University, Heidelberg, Germany.
8
Division of Neurosurgery, Hospital for Sick Children and Toronto Western Hospital, Toronto, Ontario, Canada.
9
Department of Neurological Surgery, University of Washington and Seattle Children's Hospital, Seattle, Washington Jeff.Ojemann@seattlechildrens.org.

Abstract

Desmoplastic infantile ganglioglioma (DIG) and desmoplastic infantile astrocytoma (DIA) are extremely rare tumors that typically arise in infancy; however, these entities have not been well characterized in terms of genetic alterations or clinical outcomes. Here, through a multi-institutional collaboration, the largest cohort of DIG/DIA to date is examined using advanced laboratory and data processing techniques. Targeted DNA exome sequencing and DNA methylation profiling were performed on tumor specimens obtained from different patients (n = 8) diagnosed histologically as DIG/DIGA. Two of these cases clustered with other tumor entities, and were excluded from analysis. The remaining 16 cases were confirmed to be DIG/DIA by histology and by DNA methylation profiling. Somatic BRAF gene mutations were discovered in 7 instances (43.8%); 4 were BRAFV600E mutations, and 3 were BRAFV600D mutations. Three instances of malignant transformation were found, and sequencing of the recurrence demonstrated a new TP53 mutation in one case, new ATRX deletion in one case, and in the third case, the original tumor harbored an EML4-ALK fusion, also present at recurrence. DIG/DIA are distinct pathologic entities that frequently harbor BRAFV600 mutations. Complete surgical resection is the ideal treatment, and overall prognosis is excellent. While, the small sample size and incomplete surgical records limit a definitive conclusion about the risk of tumor recurrence, the risk appears quite low. In rare cases with wild-type BRAF, malignant progression can be observed, frequently with the acquisition of other genetic alterations.Implications: DIG/DIA are a distinct molecular entity, with a subset frequently harboring either BRAF V600E or BRAF V600D mutations. Mol Cancer Res; 16(10); 1491-8. ©2018 AACR.

PMID:
30006355
DOI:
10.1158/1541-7786.MCR-17-0507
[Indexed for MEDLINE]
Free full text

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center