Clonal evidence for the progression of a testicular germ cell tumor to angiosarcoma

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Abstract

Testicular germ cell tumors may have multiple histologic subtypes. Teratoma components are capable of transformation into somatic malignancies. An alternative hypothesis for the development of angiosarcoma in a patient with germ cell tumors is secondary to radiation or chemotherapy. We report a patient with a mixed testicular germ cell tumor who presented with retroperitoneal, mediastinal, and pulmonary metastases after chemotherapy. Forty months after his original diagnosis, a mediastinal angiosarcoma was diagnosed. Using tissue microdissection-loss of heterozygosity analysis and fluorescence in situ hybridization, we analyzed the clonality of the primary germ cell tumor, angiosarcoma, and metastatic teratoma. Six microsatellite polymorphic markers from 3 different chromosomes were used to examine the pattern of allelic loss; chromosome 12p alterations, including isochromosome 12p and 12p overrepresentation, were investigated. Loss of heterozygosity was demonstrated for microsatellite loci of all 3 chromosomes, and completely concordant loss of heterozygosity patterns were observed among primary germ cell tumor components, metastatic teratoma, and angiosarcoma. Isochromosome 12p and 12p overrepresentations were consistently found in the primary germ cell tumor components, metastatic teratoma, and angiosarcoma. The results indicated a clonal origin of the tumors, which supports that angiosarcoma, as well as the teratomas, arose from the testicular germ cell tumors.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalHuman Pathology
Volume41
Issue number1
DOIs
StatePublished - Jan 2010

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Hemangiosarcoma
Teratoma
Loss of Heterozygosity
Germ Cell and Embryonal Neoplasms
Isochromosomes
Chromosomes, Human, Pair 3
Cellular Structures
Microsatellite Repeats
Drug Therapy
Microdissection
Fluorescence In Situ Hybridization
Testicular Germ Cell Tumor
Neoplasms
Chromosomes
Radiation
Neoplasm Metastasis
Lung

Keywords

  • Angiosarcoma
  • Chemotherapy
  • Clonality
  • Germs cell tumors
  • Loss of heterozygosity
  • Teratoma
  • Testis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

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title = "Clonal evidence for the progression of a testicular germ cell tumor to angiosarcoma",
abstract = "Testicular germ cell tumors may have multiple histologic subtypes. Teratoma components are capable of transformation into somatic malignancies. An alternative hypothesis for the development of angiosarcoma in a patient with germ cell tumors is secondary to radiation or chemotherapy. We report a patient with a mixed testicular germ cell tumor who presented with retroperitoneal, mediastinal, and pulmonary metastases after chemotherapy. Forty months after his original diagnosis, a mediastinal angiosarcoma was diagnosed. Using tissue microdissection-loss of heterozygosity analysis and fluorescence in situ hybridization, we analyzed the clonality of the primary germ cell tumor, angiosarcoma, and metastatic teratoma. Six microsatellite polymorphic markers from 3 different chromosomes were used to examine the pattern of allelic loss; chromosome 12p alterations, including isochromosome 12p and 12p overrepresentation, were investigated. Loss of heterozygosity was demonstrated for microsatellite loci of all 3 chromosomes, and completely concordant loss of heterozygosity patterns were observed among primary germ cell tumor components, metastatic teratoma, and angiosarcoma. Isochromosome 12p and 12p overrepresentations were consistently found in the primary germ cell tumor components, metastatic teratoma, and angiosarcoma. The results indicated a clonal origin of the tumors, which supports that angiosarcoma, as well as the teratomas, arose from the testicular germ cell tumors.",
keywords = "Angiosarcoma, Chemotherapy, Clonality, Germs cell tumors, Loss of heterozygosity, Teratoma, Testis",
author = "Muhammad Idrees and Matthew Kuhar and Thomas Ulbright and Shaobo Zhang and Narsimhan Agaram and Mingsheng Wang and David Grignon and John Eble and Liang Cheng",
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AU - Idrees, Muhammad

AU - Kuhar, Matthew

AU - Ulbright, Thomas

AU - Zhang, Shaobo

AU - Agaram, Narsimhan

AU - Wang, Mingsheng

AU - Grignon, David

AU - Eble, John

AU - Cheng, Liang

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N2 - Testicular germ cell tumors may have multiple histologic subtypes. Teratoma components are capable of transformation into somatic malignancies. An alternative hypothesis for the development of angiosarcoma in a patient with germ cell tumors is secondary to radiation or chemotherapy. We report a patient with a mixed testicular germ cell tumor who presented with retroperitoneal, mediastinal, and pulmonary metastases after chemotherapy. Forty months after his original diagnosis, a mediastinal angiosarcoma was diagnosed. Using tissue microdissection-loss of heterozygosity analysis and fluorescence in situ hybridization, we analyzed the clonality of the primary germ cell tumor, angiosarcoma, and metastatic teratoma. Six microsatellite polymorphic markers from 3 different chromosomes were used to examine the pattern of allelic loss; chromosome 12p alterations, including isochromosome 12p and 12p overrepresentation, were investigated. Loss of heterozygosity was demonstrated for microsatellite loci of all 3 chromosomes, and completely concordant loss of heterozygosity patterns were observed among primary germ cell tumor components, metastatic teratoma, and angiosarcoma. Isochromosome 12p and 12p overrepresentations were consistently found in the primary germ cell tumor components, metastatic teratoma, and angiosarcoma. The results indicated a clonal origin of the tumors, which supports that angiosarcoma, as well as the teratomas, arose from the testicular germ cell tumors.

AB - Testicular germ cell tumors may have multiple histologic subtypes. Teratoma components are capable of transformation into somatic malignancies. An alternative hypothesis for the development of angiosarcoma in a patient with germ cell tumors is secondary to radiation or chemotherapy. We report a patient with a mixed testicular germ cell tumor who presented with retroperitoneal, mediastinal, and pulmonary metastases after chemotherapy. Forty months after his original diagnosis, a mediastinal angiosarcoma was diagnosed. Using tissue microdissection-loss of heterozygosity analysis and fluorescence in situ hybridization, we analyzed the clonality of the primary germ cell tumor, angiosarcoma, and metastatic teratoma. Six microsatellite polymorphic markers from 3 different chromosomes were used to examine the pattern of allelic loss; chromosome 12p alterations, including isochromosome 12p and 12p overrepresentation, were investigated. Loss of heterozygosity was demonstrated for microsatellite loci of all 3 chromosomes, and completely concordant loss of heterozygosity patterns were observed among primary germ cell tumor components, metastatic teratoma, and angiosarcoma. Isochromosome 12p and 12p overrepresentations were consistently found in the primary germ cell tumor components, metastatic teratoma, and angiosarcoma. The results indicated a clonal origin of the tumors, which supports that angiosarcoma, as well as the teratomas, arose from the testicular germ cell tumors.

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