Multiregion sequencing of sarcomatoid renal cell carcinoma arising from autosomal dominant polycystic kidney disease. Issue 3 (5th February 2022)

• Record Type: Journal Article
• Authors: Lee, Elizabeth; Guan, Peiyong; Lim, Abner Herbert; Loh, Jui Wan; Tan, Grace Fangmin; Loh, Tracy; Ng, Dave Yong Xiang; Lee, Jing Yi; Goh, Shane; Liu, Wei; Ng, Cedric Chuan‐Young; Teh, Bin Tean; Chan, Jason Yongsheng
• Is Part Of: Molecular genetics & genomic medicine. Volume 10:Issue 3(2022)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-02-05
• Subjects: genetics -- hereditary -- phylogeny -- tumor evolution; Medical genetics -- Periodicals; Genomics -- Periodicals; 616.042
• DOI: 10.1002/mgg3.1853
• Languages: English
• ISSNs: 2324-9269

Abstract

Abstract: Background: Autosomal dominant polycystic kidney disease (ADPKD) is an inherited cystic kidney disease associated with a spectrum of various renal and extrarenal manifestations, including increased risk of kidney cancers. Here, we present the initial molecular description of sarcomatoid renal cell carcinoma (sRCC) arising in the setting of ADPKD. Methods: Multiregion whole‐exome sequencing and whole transcriptomic sequencing were used to examine intratumoral molecular heterogeneity among histologically‐distinct spindle (sarcomatoid), epithelioid, or biphasic compartments within the tumor and compared with the non‐malignant ADPKD component. Results: Spindle and biphasic components harbored several overlapping driver gene mutations, but do not share any with the epithelioid component. Mutations in ATM, CTNNB1, and NF2 were present only in the biphasic and spindle components, while mutations in BID, FLT3, ARID1B, and SMARCA2 were present only in the epithelioid component. We observed dichotomous evolutionary pathways in the development of epithelioid and spindle compartments, involving early mutations in TP53 and ATM / CTNNB1 / NF2 respectively. Wnt, PI3K‐mTOR, and MAPK signaling pathways, known key mechanisms involved in ADPKD development, featured prominently in the sarcomatoid component. Conclusion: This highlights that common pro‐oncogenic signals are present between ADPKD and sRCC providing insights into their shared pathobiology. Abstract : In this paper, we describe a rare occurrence of sarcomatoid renal cell cancer (sRCC) in a patient with autosomal dominant polycystic kidney disease. We applied multiregion whole exome sequencing and whole transcriptomic sequencing to investigate intratumoural molecular heterogeneity. Dichotomous evolutionary pathways in the development of distinct spindle and epithelioid elements were uncovered, while common pro‐oncogenic signals present between ADPKD and sRCC were highlighted, providing insights into their shared pathobiology.