Genomic analysis of primary epithelial neoplasms of the seminal vesicle identifies a subset of mucinous cystic tumours driven by KRAS mutations

Histopathology. 2024 Jun;84(7):1192-1198. doi: 10.1111/his.15167. Epub 2024 Feb 26.

Abstract

Background: Carcinomas of the seminal vesicle are exceedingly rare, with a limited number of cases described in the literature. Reported cases span a relatively wide morphological spectrum, and their genomic features remain unexplored.

Design: In this study, we interrogated five primary epithelial neoplasms of the seminal vesicle using a targeted DNA sequencing platform (OncoPanel, 447 genes).

Results: The tumours included one adenocarcinoma with intestinal phenotype presenting after external beam radiation (for prostatic adenocarcinoma), one carcinoma with Müllerian-type clear cell phenotype, two mucinous tumours resembling low-grade mucinous neoplasms of the appendix (LAMN) and one mucinous cystadenoma. The post-radiation mucinous adenocarcinoma had genomic findings consistent with bi-allelic inactivation of TP53, as well as multiple copy-number changes with regional and chromosomal arm-level copy-number losses. The Müllerian-type clear cell carcinoma exhibited a complex copy-number profile with numerous regional and arm-level copy-number changes, as well as focal amplification events, including copy-number gain of 8q and amplification of a region within 20q13. Both low-grade mucinous tumours resembling LAMN harboured hot-spot gain-of-function KRAS variants (p.G12V and p.G13D) as the only genomic alteration. No genomic alterations were detected inthe lesion diagnosed as mucinous cystadenoma.

Conclusion: Our results suggest that primary low-grade mucinous neoplasms of the seminal vesicle may represent a distinct entity equivalent to appendiceal counterparts, driven by gain-of-function variants of RAS GTPases. The remaining tumours showed genomic features that closely resembled those of neoplasms with comparable phenotypes and/or biological characteristics arising in other sites, suggesting that they could be managed similarly, with special considerations related to their anatomical location.

Keywords: KRAS; mucinous cystic neoplasm; seminal vesicle, neoplasm.

MeSH terms

  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology
  • Adult
  • Aged
  • Cystadenoma, Mucinous / genetics
  • Cystadenoma, Mucinous / pathology
  • Humans
  • Male
  • Middle Aged
  • Neoplasms, Cystic, Mucinous, and Serous* / genetics
  • Neoplasms, Cystic, Mucinous, and Serous* / pathology
  • Neoplasms, Glandular and Epithelial* / genetics
  • Neoplasms, Glandular and Epithelial* / pathology
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Seminal Vesicles* / pathology
  • Young Adult

Substances

  • KRAS protein, human
  • Proto-Oncogene Proteins p21(ras)