1. SMARCA4-deficient central nervous system metastases: A case series and systematic review.
- Author
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Morris M, Ararat K, Cutshall H, Gokden M, Rodriguez A, Rooper L, Lindberg M, and Nix JS
- Subjects
- Humans, Middle Aged, Female, Male, Aged, Lung Neoplasms pathology, Lung Neoplasms genetics, Lung Neoplasms secondary, Adult, Transcription Factors genetics, Transcription Factors deficiency, DNA Helicases deficiency, DNA Helicases genetics, Nuclear Proteins genetics, Nuclear Proteins deficiency, Central Nervous System Neoplasms secondary, Central Nervous System Neoplasms pathology, Central Nervous System Neoplasms genetics
- Abstract
SMARCA4 alterations can be encountered in a variety of human neoplasms, and metastases to the central nervous system (CNS) are rare, offering a challenge to neuropathologists despite not representing a distinct diagnostic entity. To better understand the clinical and histologic presentation of such neoplasms, we report an observational case series and systematic review of 178 unique articles that yielded 15 published cases and 7 cases from institutional files. In the systematic review, the median age was 58 years, the male-to-female ratio was 2:1, and the most common diagnosis was lung adenocarcinoma; all CNS metastases were discovered within 1 year of presentation. In the case series, the median age was 58 years, the male-to-female ratio was 6:1, and all known metastases originated from the lung. Most patients had a smoking history and died of disease. GATA-3 positivity was seen in most case series examples. Concurrent TP53 mutations (83.3%) and a high tumor mutation rate (60%) were common. To our knowledge, this is the only case series and systematic review in the English literature aimed at assessing SMARCA4-altered metastases in the CNS and vertebral column. We highlight the challenges of neuropathologic evaluation of such tumors and provide observational evidence of early metastases, histologic appearances, and immunohistochemical findings, including previously unreported GATA-3 positivity., (© The Author(s) 2024. Published by Oxford University Press on behalf of American Association of Neuropathologists, Inc. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
- Published
- 2024
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