Cutaneous metastasis of SMARCA4-deficient thoracic sarcoma: A diagnostic dilemma with therapeutic implications

J Cutan Pathol. 2020 Jun;47(6):561-565. doi: 10.1111/cup.13652. Epub 2020 Feb 13.

Abstract

SMARCA4-deficient thoracic sarcoma (SMARCA4-DTS) is a recently recognized entity with undifferentiated rhabdoid morphology and mutations in the switch/sucrose nonfermenting BRG1-associated factors complex. Patients are typically males in their fifth decade with a history of smoking who present with rapidly progressive intrathoracic disease and follow an aggressive clinical course. Metastatic disease is reported in up to 77% of cases; however, to our knowledge, cutaneous metastasis has not been reported nor has it been reported as the initial manifestation of the disease. Recognizing SMARCA4-DTS from other types of epithelioid tumors that involve the skin is clinically relevant, as targeted therapies for SMARC-deficient tumors are currently being investigated and early clinical trial data show therapeutic benefit.

Keywords: SMARCA4; epithelioid; sarcoma.

Publication types

  • Case Reports

MeSH terms

  • Antigens, CD34 / metabolism
  • DNA Helicases / genetics*
  • Disease Progression
  • Drug Therapy / methods
  • Epithelioid Cells / pathology
  • Fatal Outcome
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Nuclear Proteins / genetics*
  • Sarcoma / diagnosis
  • Sarcoma / drug therapy
  • Sarcoma / genetics*
  • Sarcoma / pathology
  • Skin Neoplasms / secondary*
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Soft Tissue Neoplasms / pathology*
  • Thoracic Neoplasms / pathology
  • Transcription Factors / genetics*

Substances

  • Antigens, CD34
  • Nuclear Proteins
  • Transcription Factors
  • SMARCA4 protein, human
  • DNA Helicases