Expanding the differential of superficial tumors with round-cell morphology: Report of three cases of CIC-rearranged sarcoma, a potentially under-recognized entity

J Cutan Pathol. 2020 Jun;47(6):535-540. doi: 10.1111/cup.13639. Epub 2020 Jan 10.

Abstract

Among sarcomas with a round-cell morphology that lack rearrangement of the EWSR1 gene, rearrangements involving the CIC gene are the most common. In comparison with Ewing Sarcoma, CIC-rearranged sarcomas present at an older average age, arise almost exclusively in soft tissues, are clinically more aggressive, and are more likely to be resistant to the chemotherapy regimens used for Ewing sarcoma. CIC-rearranged sarcomas present more commonly in a deep location, and we suspect that superficial presentations may be under-recognized. In this case series, we report three of such cases. Overall, the morphology is similar to CIC-rearranged sarcomas of deeper locations. We hope to raise awareness among the dermatopathology community by expanding the differential of superficial tumors with round cell morphology.

Keywords: CIC; CIC-DUX; CIC-DUX4; CIC-rearranged; round-cell sarcoma.

Publication types

  • Case Reports

MeSH terms

  • 12E7 Antigen / metabolism
  • Adult
  • Bone Neoplasms / pathology
  • Female
  • Gene Rearrangement
  • High-Throughput Nucleotide Sequencing / methods
  • Homeodomain Proteins / metabolism
  • Humans
  • Immunohistochemistry / methods
  • In Situ Hybridization, Fluorescence / methods
  • Male
  • Middle Aged
  • Oncogene Proteins, Fusion / genetics*
  • Repressor Proteins / genetics*
  • Sarcoma / pathology
  • Sarcoma, Ewing / genetics*
  • Sarcoma, Small Cell / genetics*
  • Sarcoma, Small Cell / pathology
  • Sarcoma, Small Cell / ultrastructure
  • Soft Tissue Neoplasms / pathology

Substances

  • 12E7 Antigen
  • CD99 protein, human
  • CIC protein, human
  • CIC-DUX4 fusion protein, human
  • DUX4L1 protein, human
  • Homeodomain Proteins
  • Oncogene Proteins, Fusion
  • Repressor Proteins