Primary Spindle Cell Sarcoma of the Lung with MGA::NUTM1 Fusion: An Extremely Rare Case of a Potentially Emerging Entity and Review of the Literature

Int J Surg Pathol. 2022 Dec;30(8):931-938. doi: 10.1177/10668969221092125. Epub 2022 Apr 7.

Abstract

Originally described in a rare subset of poorly differentiated squamous cell carcinomas termed NUT carcinomas, NUTM1 rearrangements are now known to characterize a wide spectrum of neoplasms including sarcomas, poromas/porocarcinomas, unclassified adnexal carcinomas and pediatric acute lymphoblastic leukemia. The advent of next-generation sequencing (NGS) has led to the identification of a multitude of novel fusion partners in addition to BRD4, which was initially reported in the majority of NUT carcinomas. NUTM1-rearranged sarcomas usually harbor fusions with the MAD gene family (MXD1, MXD4, MGA) and present as spindle cell proliferations in diverse locations in patients of all ages. Herein, we present a very rare case of spindle cell sarcoma of the lung, which harbored a NUTM1::MGA fusion and offer a comprehensive update of the recent data.

Keywords: MGA::NUTM1; NUT carcinoma; NUTM1-rearranged sarcoma; next generation sequencing; spindle cell sarcoma.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Basic Helix-Loop-Helix Leucine Zipper Transcription Factors
  • Carcinoma* / genetics
  • Cell Cycle Proteins
  • Child
  • Humans
  • Lung / pathology
  • Neoplasm Proteins / genetics
  • Nuclear Proteins / genetics
  • Oncogene Proteins, Fusion / genetics
  • Repressor Proteins / genetics
  • Sarcoma* / diagnosis
  • Sarcoma* / genetics
  • Sarcoma* / pathology
  • Soft Tissue Neoplasms* / pathology
  • Transcription Factors / genetics

Substances

  • Transcription Factors
  • Nuclear Proteins
  • Neoplasm Proteins
  • Oncogene Proteins, Fusion
  • MXD1 protein, human
  • Repressor Proteins
  • Basic Helix-Loop-Helix Leucine Zipper Transcription Factors
  • BRD4 protein, human
  • Cell Cycle Proteins