STBT5:CIC-rearranged sarcoma

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Primary Author(s)*

Ganesh P. Pujari, M.D, FICC and Katherine Geiersbach, M.D.

WHO Classification of Disease

(Will be autogenerated; Book will include name of specific book and have a link to the online WHO site)

Structure	Disease
Book
Category
Family
Type
Subtype(s)

Definition / Description of Disease

Previously grouped into Ewing and other primitive sarcoma categories, it was not until 2006 that the CIC-rearranged sarcomas were identified as a distinct subgroup of soft tissue neoplasms in the “Ewing-like sarcomas” category. Apart from the classical DUX4, approximately 8 other partner genes have been reported so far. Overall due to its characteristic histomorphologic and immunophenotypic features, diagnostic molecular rearrangements, highly aggressive clinical course, poor response to chemotherapy and adverse outcome (compared to Ewing sarcoma) CIC-rearranged sarcoma has been recognized as a distinct pathologic entity by the WHO under the category of undifferentiated small round cell sarcomas of bone and soft tissue and grouped along with the sarcoma with BCOR genetic alterations, and round cell sarcoma with EWSR1::non-ETS fusions.

Synonyms / Terminology

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Epidemiology / Prevalence

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Clinical Features

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Signs and Symptoms	EXAMPLE: Asymptomatic (incidental finding on complete blood counts) EXAMPLE: B-symptoms (weight loss, fever, night sweats) EXAMPLE: Lymphadenopathy (uncommon)
Laboratory Findings	EXAMPLE: Cytopenias EXAMPLE: Lymphocytosis (low level)

Sites of Involvement

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Morphologic Features

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Immunophenotype

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Finding	Marker
Positive (universal)	EXAMPLE: CD1
Positive (subset)
Negative (universal)
Negative (subset)

Chromosomal Rearrangements (Gene Fusions)

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Chromosomal Rearrangement	Genes in Fusion (5’ or 3’ Segments)	Pathogenic Derivative	Prevalence	Diagnostic Significance (Yes, No or Unknown)	Prognostic Significance (Yes, No or Unknown)	Therapeutic Significance (Yes, No or Unknown)	Notes
EXAMPLE: t(9;22)(q34;q11.2)	EXAMPLE: 3'ABL1 / 5'BCR	EXAMPLE: der(22)	EXAMPLE: 20% (COSMIC) EXAMPLE: 30% (add reference)	EXAMPLE: Yes	EXAMPLE: No	EXAMPLE: Yes	EXAMPLE:The t(9;22) is diagnostic of CML in the appropriate morphology and clinical context (add reference). This fusion is responsive to targeted therapy such as Imatinib (Gleevec) (add reference).

Individual Region Genomic Gain / Loss / LOH

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Chr #	Gain / Loss / Amp / LOH	Minimal Region Genomic Coordinates [Genome Build]	Minimal Region Cytoband	Diagnostic Significance (Yes, No or Unknown)	Prognostic Significance (Yes, No or Unknown)	Therapeutic Significance (Yes, No or Unknown)	Notes
EXAMPLE:7	EXAMPLE: Loss	EXAMPLE:chr7:1-159,335,973 [hg38]	EXAMPLE:chr7	EXAMPLE: Yes	EXAMPLE: Yes	EXAMPLE: No	EXAMPLE:Presence of monosomy 7 (or 7q deletion) is sufficient for a diagnosis of AML with MDS-related changes when there is ≥20% blasts and no prior therapy (add reference).  Monosomy 7/7q deletion is associated with a poor prognosis in AML (add reference).
EXAMPLE:8	EXAMPLE: Gain	EXAMPLE:chr8:1-145,138,636 [hg38]	EXAMPLE:chr8	EXAMPLE: No	EXAMPLE: No	EXAMPLE: No	EXAMPLE:Common recurrent secondary finding for t(8;21) (add reference).

Characteristic Chromosomal Patterns

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Chromosomal Pattern	Diagnostic Significance (Yes, No or Unknown)	Prognostic Significance (Yes, No or Unknown)	Therapeutic Significance (Yes, No or Unknown)	Notes
EXAMPLE:Co-deletion of 1p and 18q	EXAMPLE: Yes	EXAMPLE: No	EXAMPLE: No	EXAMPLE:See chromosomal rearrangements table as this pattern is due to an unbalanced derivative translocation associated with oligodendroglioma (add reference).

Gene Mutations (SNV / INDEL)

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Gene; Genetic Alteration	Presumed Mechanism (Tumor Suppressor Gene [TSG] / Oncogene / Other)	Prevalence (COSMIC / TCGA / Other)	Concomitant Mutations	Mutually Exclusive Mutations	Diagnostic Significance (Yes, No or Unknown)	Prognostic Significance (Yes, No or Unknown)	Therapeutic Significance (Yes, No or Unknown)	Notes
EXAMPLE: TP53; Variable LOF mutations EXAMPLE: EGFR; Exon 20 mutations EXAMPLE: BRAF; Activating mutations	EXAMPLE: TSG	EXAMPLE: 20% (COSMIC) EXAMPLE: 30% (add Reference)	EXAMPLE: IDH1 R123H	EXAMPLE: EGFR amplification	EXAMPLE: Yes	EXAMPLE: No	EXAMPLE: No	EXAMPLE: Excludes hairy cell leukemia (HCL) (add reference).

Note: A more extensive list of mutations can be found in cBioportal (https://www.cbioportal.org/), COSMIC (https://cancer.sanger.ac.uk/cosmic), ICGC (https://dcc.icgc.org/) and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.

Epigenomic Alterations

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Genes and Main Pathways Involved

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Gene; Genetic Alteration	Pathway	Pathophysiologic Outcome
EXAMPLE: BRAF and MAP2K1; Activating mutations	EXAMPLE: MAPK signaling	EXAMPLE: Increased cell growth and proliferation
EXAMPLE: CDKN2A; Inactivating mutations	EXAMPLE: Cell cycle regulation	EXAMPLE: Unregulated cell division
EXAMPLE: KMT2C and ARID1A; Inactivating mutations	EXAMPLE: Histone modification, chromatin remodeling	EXAMPLE: Abnormal gene expression program

Genetic Diagnostic Testing Methods

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Familial Forms

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Additional Information

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Links

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References

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Notes

*Primary authors will typically be those that initially create and complete the content of a page.  If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the CCGA coordinators (contact information provided on the homepage).  Additional global feedback or concerns are also welcome.