SMARCA4-deficient thoracic sarcoma revealed by metastasis to the small intestine: a diagnostic dilemma

Gen Thorac Cardiovasc Surg. 2021 Jul;69(7):1155-1158. doi: 10.1007/s11748-021-01627-z. Epub 2021 Apr 17.

Abstract

SMARCA4-deficient thoracic sarcoma (SMARCA4-DTS) is a recently identified aggressive subtype of sarcoma. We present the case of a 44-year-old man who underwent a surgery for a perforated small intestine. Compued tomography scan revealed a tissular mediastino-pulmonary mass.Histopathological examination of the intestinal mass shown a malignant tumour with a typical epithelioid and rhabdoid cells, numerous mitoses and large necrosis. A large panel of immunohistochemistry revealed loss of SMARCA4 and SMARCA2 and allowed the diagnosis of SMARCA4-DTS. It is important to consider SMARCA4-deficient thoracic sarcoma in the differential diagnosis of tumours showing suggestive morphologic features in patients of all ages, especially in the case of metastasis associated with thoracic mass.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biomarkers, Tumor / genetics
  • DNA Helicases
  • Humans
  • Immunohistochemistry
  • Intestine, Small / surgery
  • Male
  • Nuclear Proteins / genetics
  • Sarcoma* / diagnosis
  • Sarcoma* / genetics
  • Sarcoma* / surgery
  • Thoracic Neoplasms* / diagnosis
  • Thoracic Neoplasms* / genetics
  • Thoracic Neoplasms* / surgery
  • Transcription Factors / genetics

Substances

  • Biomarkers, Tumor
  • Nuclear Proteins
  • Transcription Factors
  • SMARCA4 protein, human
  • DNA Helicases