ESWR1-CREM Fusion in an Intracranial Myxoid Angiomatoid Fibrous Histiocytoma-Like Tumor: A Case Report and Literature Review

J Neuropathol Exp Neurol. 2018 Jul 1;77(7):537-541. doi: 10.1093/jnen/nly039.

Abstract

Gene fusions of EWSR1 with members of the CREB family of transcription factors (CREB1, ATF1, and CREM) have recently been described in exceptional intracranial myxoid mesenchymal tumors. Although this is a known gene fusion found in various mesenchymal tumors, EWSR1 fusion with CREM has only been observed in 3 intracranial myxoid tumors. In this paper, we present 1 such tumor with in-depth histopathological description and long-term follow-up. There is controversy regarding whether these tumors represent a novel entity or simply an intracranial localization of the myxoid variant of angiomatoid fibrous histiocytoma, a rare soft tissue tumor of the extremities. Out of 11 cases mentioned in the literature, the 3 isolated case reports by Dunham et al, Ochalski et al, and Alshareef et al are designated as angiomatoid fibrous histiocytoma, whereas the others are defined as a novel tumoral entity called intracranial myxoid mesenchymal tumor with EWSR1-CREB fusion. We believe the vast morphological and immunohistochemical spectrum of angiomatoid fibrous histiocytoma makes it difficult to dismiss this diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Brain Neoplasms / genetics*
  • Brain Neoplasms / pathology*
  • Brain Neoplasms / surgery
  • Cyclic AMP Response Element Modulator / genetics*
  • Female
  • Histiocytoma, Malignant Fibrous / genetics*
  • Histiocytoma, Malignant Fibrous / pathology*
  • Histiocytoma, Malignant Fibrous / surgery
  • Humans
  • Immunohistochemistry
  • Neoplasm Recurrence, Local
  • Neurosurgical Procedures
  • Oncogene Proteins, Fusion / genetics*
  • RNA-Binding Protein EWS / genetics*
  • Treatment Outcome
  • Young Adult

Substances

  • CREM protein, human
  • EWSR1 protein, human
  • Oncogene Proteins, Fusion
  • RNA-Binding Protein EWS
  • Cyclic AMP Response Element Modulator

Supplementary concepts

  • Histiocytoma, Angiomatoid Fibrous