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Objectives: Intimal sarcoma is a rare vascular malignancy with a poor prognosis and no established treatment. This study aimed to identify clinicopathological and transcriptomic factors associated with disease progression to uncover potential therapeutic targets.
Methods: Ten patients with surgically resected intimal sarcoma were included. Ribonucleic acid (RNA) sequencing was performed on formalin-fixed, paraffin-embedded tumour samples, of which 8 passed quality control. Patients were stratified by the median overall survival of 17 months. Differentially expressed genes (DEGs) were identified and analysed using Gene Ontology (GO), Enrichr, and Gene Set Enrichment Analysis (GSEA). Immunohistochemistry was used to validate selected protein expression.
Results: The primary tumour site was the pulmonary artery in 8 cases and the heart in 2 cases. The median survival was 17 months, with a 5-year survival rate of 13.3%. Twenty-eight DEGs (|logFC| > 2, P < 0.01) were identified, most of which were upregulated in poor-prognosis tumours. GO and Enrichr analyses revealed enrichment in ribosome-related processes, including cytoplasmic translation and ribosomal biogenesis. GSEA showed enrichment of MYC targets and oxidative phosphorylation; epithelial-mesenchymal transition was moderately enriched, and myogenesis was downregulated. Immunohistochemistry confirmed overexpression of RPS27 and RPL26 in poor-prognosis tumours.
Conclusions: Transcriptomic analysis revealed upregulation of ribosome-related genes in aggressive intimal sarcoma. Aberrant protein synthesis may contribute to poor prognosis and represent a novel therapeutic vulnerability.
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http://dx.doi.org/10.1093/ejcts/ezaf245 | DOI Listing |
Case Rep Oncol
February 2025
Department of Cardiac, Thoracic and Vascular Surgery, Hospital of Lithuanian University of Health Sciences Kauno Klinikos, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Introduction: Primary malignant aortic tumors are rare and diagnosis can be difficult due to the variety of clinical manifestations. This malignant disease, which originates in the intima or medial layers of the aorta, presents a complex diagnostic and therapeutic dilemma. Due to their insidious growth and nonspecific symptoms, they are often diagnosed postmortem.
View Article and Find Full Text PDFCardiovasc Pathol
July 2025
Department of Pathology, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, Republic of Korea. Electronic address:
Cardiac undifferentiated pleomorphic sarcomas (UPS) are extremely rare tumors that typically arise in the left atrium. They behave highly aggressively, requiring multimodality treatment when complete surgical resection is not feasible. Nevertheless, there is ongoing debate regarding the efficacy of adjuvant radiation therapy and the associated risk of radiation-induced cardiotoxicity.
View Article and Find Full Text PDFBr J Cancer
July 2025
Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada.
Background: The incidence and predictors of brain metastases (BrM) from sarcoma remain poorly characterized. We aimed to determine the cumulative incidence (CuI) and risk factors for BrM.
Methods: We retrospectively analyzed data from all sarcoma patients who presented to our center (2006-2023).
JACC Case Rep
July 2025
Department of Cardiology, Yokohama Municipal Citizen's Hospital, Yokohama, Japan.
Malignant tumors of the aortic valve are extremely rare and challenging to diagnose. Here, we present a case of a 59-year-old woman with an intimal sarcoma of the aortic valve that led to acute aortic regurgitation (AR) and recurrent acute coronary syndrome (ACS). The patient initially presented with an out-of-hospital cardiac arrest due to ACS and underwent emergent percutaneous coronary intervention.
View Article and Find Full Text PDFEur J Cardiothorac Surg
August 2025
Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Hyogo 650-0017, Japan.
Objectives: Intimal sarcoma is a rare vascular malignancy with a poor prognosis and no established treatment. This study aimed to identify clinicopathological and transcriptomic factors associated with disease progression to uncover potential therapeutic targets.
Methods: Ten patients with surgically resected intimal sarcoma were included.