Characteristic Genetic Mutations Flashcards
Odontogenic keratocyst (OKC)
PTCH mut (80%of sporadic and Gorlin-syndrome assc OKCs). Gorlin syndrome (AKA nevoid BCC syndrome): OKCs, nevoid BCC, medulloblastoma, skeletal abnormalities, ectopic soft tissue calcs, ovarian fibromas
Amelobalstoma
BRAF V600E mut
Pilocytic astrocytoma
BRAF-KIAA1549 fusions
A minority will have BRAF V600E mut
Pleomorphic adenoma (mixed tumor)
PLAG1 alterations
HMGA2 fusions less commonly seen
Adenoid cystic carcinoma
t(6;9) NFIB-MYB or -MYBL1
Less commonly t(8;9)
Secretory carcinoma
FKA Mammary analogue secretory tumor
t(12;15) ETV6-NTRK3
Polymorphous low-grade adenocarcinoma
PRKD gene rearrangements
Esp PRKD1 E710D hotspot mut
Mucoepidermoid carcinoma
t(11;19) MECT1-MAML2 or CRTC1-MAML2
Hyalinizing clear cell carcinoma (AKA clear cell carcinoma of salivary gland)
t(12;22) EWSR1-ATF1
Fibrous dysplasia
GNAS1 mut
NUT midline carcinoma
t(15;19) NUT-BRD4
t(9;15) NUT-BRD3 is less common
Think “bird” going for a nut.
Craniopharyngioma
BRAF V600E mut
Malignant melanoma of soft parts (clear-cell sarcoma)
t(12;22) EWSR1-ATF1
Nasopharyngeal angiofibroma
CTNNB1 mut in 75% (beta-catenin)
- also a/w APC mut and Familial Adenomatous Polyposis
Alveolar rhabdomyosarcoma
t(2;13) PAX3-FOXO1 (better prognosis), or
t(1;13) PAX7-FOXO1 (worse prog)
Embryonal rhabdomyosarcoma
a/w loss of chr 11
Biphenotypic Sinonasal Sarcoma (BSNS)
t(2;4) PAX3-MAML3 fusion
Rarely PAX3-FOX01 or PAX3-NCOA1
Carney complex
PRKAR1A mut (2p16 abnormalities) - Includes NAME and LAMB syndromes
NAME syndrome:
- Nevi
- Atrial myxomas
- Myxoid neurofibroma
- Ephelides
LAMB syndrome:
- Lentigines
- Atrial myxomas
- Mucocutaneous myxomas
- Blue nevi
Alveolar soft part sarcoma
t(X;17) TFE3-ASPL fusion
Aneurysmal bone cyst
t(16;17) CDH11-USP6 fusion
Angiomatoid fibrous histiocytoma
t(12;16) FUS-ATF1 fusion
t(12;22) EWSR1-ATF1 fusion
t(2;22) EWSR1-CREB1 fusion
Extraskeletal myxoid chondrosarcoma
t(9;22) EWSR1-NR4A3 fusion
t(9;17) TAF2N-NR4A3 fusion
t(9;15) TCF12-NR4A3 fusion
t(3;9) TFG-NR4A3 fusion
Clear cell sarcoma
t(12;22) EWSR1-ATF1 fusion
t(2;22) EWSR1-CREB1 fusion
Desmoplastic small round cell tumor
t(11;22) EWSR1-WT1 fusion
Dermatofibrosarcoma protuberans
Ring form of chromosomes 17 and 22 COL1A1-PDGFB fusion
t(17;22) COL1A1-PDGFB fusion
Ewing sarcoma/PNET
t(21;22) EWSR1-ERG fusion t(2;22) EWSR1-FEV fusion t(7;22) EWSR1-ETV1 fusion t(17;22) EWSR1-E1AF fusion inv(22) EWSR1-ZSG fusion t(16;21) FUS-ERG fusion t(19;der)ins.inv(21;22) EWSR1-ERG fusion t(17;22) EWSR1-ETV4 fusion t(6;22) EWSR1-POU5F1 fusion t(1;22) EWSR1-PATZ1 fusion t(2;22) EWSR!-SP3 fusion t(20;22) EWSR1-NFATC2 fusion t(2;16) FUS-FEV fusion
Undifferentiated round cell sarcoma (“atypical Ewing sarcoma”)
t(4;19)(q35;q13) CIC-DUX4 fusion
BCOR-rearranged sarcoma
AKA infantile undifferentiated round cell sarcoma
AKA primitive myxoid mesenchymal tumour of infancy
Xp11 BCOR-CCNB3
Infantile Fibrosarcoma
t(12;15) ETV6-NTRK3 fusion
Trisomies 8, 11, 17, and 20
Inflammatory myofibroblastic tumor
t(1;2) TPM3-ALK fusion t(2;19) TPM4-ALK fusion t(2;17) CLTC-ALK fusion t(2;2) RANB2-ALK fusion t(2;2) ATIC-ALK fusion t(2;11) CARS-ALK fusion t(2;4) SEC31L1-ALK fusion t(2;12) PPFIBP1-ALK fusion
Leiomyosarcoma
Complex with frequent deletion of 1p
Well-differentiated Liposarcoma
Ring form of chromosome 12
Amplification of MDM2, CDK4, and others
Myxoid/Round cell Liposarcoma
t(12;16) FUS-DDIT3 fusion
t(12;22) EWSR1-DDIT3 fusion
Low-grade fibromyxoid sarcoma
t(7;16) FUS-CREB3L2 fusion
t(11;16) FUS-CREB3L1 fusion
Rhabdoid tumor
Deletion of 22q
INI1(SMARCB1) inactivation
Alveolar Rhabdomyosarcoma
t(2;13) PAX3-FOXO1A fusion
t(1;13) double minutes PAX7-FOXO1A fusion
t(2 ;2) PAX3-NCOA1 fusion
t(X;2) PAX3-AFX fusion
Embryonal Rhabdomyosarcoma
Trisomies 2q, 8 and 20
Loss of heterozygosity at 11p15
Solitary fibrous tumor
Inversion chromosome 12
NAB2-STAT6
Synovial sarcoma
t(X;18) SS18-SSX1, SS18-SSX2 or SS18-SSX4 fusion
Monophasic SS is predominantly SS18-SSX1 fusion
Acute myelocytic leukemia (2)
t(8;21) AML1-RUNX1
Inv(16)
Acute promyelocytic leukemia
t(15;17) PML-RARA
Burkitt lymphoma
t(8;14) cMYC-IGH
Follicular lymphoma
t(14;18) IGH-BCL2
Mantle cell lymphoma
t(11;14) IGH-BCL1 (CyclinD1)
Gastric MALT lymphoma
t(11;18) API2-MALT1
CLL (5)
Deletion 13q (50%) - intermediate prog Trisomy 12 (15-20%) - poor prog Del(11q), del(14q), del(17p) (Less common) - poor prog
Intraductal papillary mucinous neoplasm (IPMN)
- KRAS mut (78%)
- Activating GNAS (58%), highly specific
- Inactivating RHF43 mut (38%), specific
- Loss of heterozygosity, often chr 9
Follicular thyroid CA
- RAS mut (30-50%)
- PPARγ-PAX8 (20-30%)
- TERT promoter mut (20%), aggressive
Papillary thyroid CA (PTC)
- BRAF mut
- RET-PTC
- RAS
- NTRK1
Medullary thyroid CA
RET activating mut
Anaplastic thyroid CA
- P53 mut
- beta-catenin mut
- RAS mut
- BRAF mut