Primary cutaneous SMARCA4-deficient undifferentiated malignant neoplasm: A rare case report and literature review.

BRG-1 BRM INI-1 SMARCA4 SMARCA4-deficient undifferentiated skin neoplasm skin tumor undifferentiated neoplasm

Journal

Journal of cutaneous pathology
ISSN: 1600-0560
Titre abrégé: J Cutan Pathol
Pays: United States
ID NLM: 0425124

Informations de publication

Date de publication:
20 Dec 2023
Historique:
revised: 15 11 2023
received: 02 08 2023
accepted: 04 12 2023
medline: 21 12 2023
pubmed: 21 12 2023
entrez: 21 12 2023
Statut: aheadofprint

Résumé

Primary cutaneous SMARCA4-deficient undifferentiated malignant neoplasm (SD-UMN) is a rare and recently described entity characterized by the loss of expression of the SMARCA4 (BRG1) protein, which is involved in chromatin remodeling. SD-UMN presents a diagnostic challenge due to its rarity and unique histopathological and immunohistochemical features. In this report, we present a case of primary cutaneous SD-UMN in a 67-year-old man who presented with a rapidly growing, ulcerated, and bleeding nodule on his right cheek. Histopathological examination revealed a highly cellular dermal tumor consisting of pleomorphic epithelioid cells with prominent mitotic figures and necrosis, lacking any morphological evidence of differentiation. Immunohistochemical analysis showed a complete loss of SMARCA4 and SMARCA2 expression, while INI-1 expression remained intact. p53 was diffusely expressed, and p16 was completely absent. In addition, a range of markers, including high-molecular-weight cytokeratin, p63, SOX10, INSM1, MCPyV, NKX2.2, CD99, CDX2, CD56, ERG, NUT, desmin, androgen receptor, chromogranin, CD34, and CD43 were all negative. To date, only two cases of primary cutaneous SMARCA4-deficient undifferentiated tumors have been reported in the literature. Therefore, this case report adds to the limited body of knowledge on the clinical and histopathological features of this novel entity. The report highlights the importance of considering SD-UMN in the differential diagnosis of undifferentiated cutaneous tumors.

Identifiants

pubmed: 38124373
doi: 10.1111/cup.14576
doi:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Références

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Auteurs

Emrah Gumusgoz (E)

Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Bradley S Graham (BS)

U.S. Dermatology Partners Tyler on Dominion Plaza, Tyler, Texas, USA.

Gregory A Hosler (GA)

Department of Pathology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA.
ProPath Dermatopathology, Dallas, Texas, USA.

Classifications MeSH