×

Please Remove Adblock
Adverts are the main source of Revenue for DoveMed. Please remove adblock to help us create the best medical content found on the Internet.

Molecular Testing for Extraskeletal Myxoid Chondrosarcoma

Last updated Feb. 28, 2017

Molecular Testing for Extraskeletal Myxoid Chondrosarcoma is a genetic test that is helpful in aiding a diagnosis of extraskeletal myxoid chondrosarcoma.


What are other Names for this Test? (Equivalent Terms)

  • Gene Mutation Analysis for Extraskeletal Myxoid Chondrosarcoma
  • Molecular Testing for EMC
  • Test for Molecular Diagnosis of Extraskeletal Myxoid Chondrosarcoma

What is Molecular Testing for Extraskeletal Myxoid Chondrosarcoma? (Background Information)

  • Molecular Testing for Extraskeletal Myxoid Chondrosarcoma is a genetic test that is helpful in aiding a diagnosis of extraskeletal myxoid chondrosarcoma. The lab test results may also be subsequently useful in taking appropriate treatment decisions
  • Extraskeletal myxoid chondrosarcoma (EMC) is an infrequent, low-grade tumor of the soft tissues, forming around bones. Middle-aged to elderly individuals are most prone to formation of this tumor
  • Most of these tumors form deep within the body tissues, though a few have been found beneath the skin surface too. The most common location for EMC is the thigh, followed by the knee, buttocks, and trunk

The cause of extraskeletal myxoid chondrosarcoma is due to genetic mutations. Currently, studies indicate defects in the following genes:

  • EWSR1-NR4A3 causing chromosomal translocation abnormality namely t(9;22)(q22;q12)
  • TAF15-NR4A3 causing chromosomal translocation abnormality namely t(9;17)(q22;q11)
  • TCF12-NR4A3 causing chromosomal translocation abnormality namely t(9;15)(q22;q21)
  • TFG-NR4A3 causing chromosomal translocation abnormality namely t(3;9)(q11;q22)

The above genetic abnormalities can be detected using molecular studies, which may play a significant role in identifying the tumor type, and in some cases, helping the healthcare provider take appropriate treatment decisions.

The molecular testing, in general, can be performed using a variety of methods. Some of these methods include:

  • In situ hybridization technique, such as fluorescence in situ hybridization (FISH)
  • Immunohistochemistry (IHC)
  • Next-generation sequencing (NGS)
  • Polymerase chain reaction (PCR)
  • Comparative genomic hybridization (CGH)
  • Karyotyping including spectral karyotyping
  • mRNA analysis
  • Tissue microarrays (TMAs)
  • Southern blot test
  • Northern blot test
  • Western blot test
  • Eastern blot test

The methodology used for extraskeletal myxoid chondrosarcoma may vary from one laboratory to another. 

Note: Molecular testing has limitations due to the molecular method and genetic mutational abnormalities being tested. This can affect the results on a case-by-case basis. Consultation with your healthcare provider will help in determining the right test and right molecular method, based on individual circumstances.

What are the Clinical Indications for performing the Molecular Testing for Extraskeletal Myxoid Chondrosarcoma Test?

Molecular Testing for Extraskeletal Myxoid Chondrosarcoma is undertaken in the following situations: 

  • To assist (and in some cases, confirm) the initial diagnosis of extraskeletal myxoid chondrosarcoma
  • To distinguish other tumors/conditions that have similar histological features, when examined by a pathologist under the microscope
  • To help in determining treatment options
  • To confirm recurrence of the tumor: Tumor recurrence can either be at the original tumor site, or at a distant location (away from the initial site)

How is the Specimen Collected for Molecular Testing for Extraskeletal Myxoid Chondrosarcoma Test?

Following is the specimen collection process for Molecular Testing for Extraskeletal Myxoid Chondrosarcoma:

The specimen sample requirements may vary from lab to lab. Hence, it is important to contact the testing lab for exact specimen requirements, before initiating the testing process.

  • Sample required:
    • Fresh tumor tissue during biopsy
    • Formalin-fixed paraffin-embedded solid tumor tissue (FFPE tumor tissue), often referred to as paraffin block of the tumor
    • Unstained tissue slides
  • Process of obtaining the sample: As outlined by the laboratory testing facility
  • Preparation required: As outlined by the laboratory testing facility

Note:

  • Depending on the location of testing, it may take up to 2 weeks’ turnaround time, to obtain the test results
  • Occasionally, additional samples may be required to either repeat the test or to perform follow-up testing
  • Many hospitals preserve the paraffin blocks for at least 7 years. In general, older paraffin blocks (over 5 years) may affect the detection of specific mutations, due to degradation of the tumor specimen over time

Cost of Molecular Testing for Extraskeletal Myxoid Chondrosarcoma:

  • The cost of the test procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities
  • In many cases, an estimate may be provided before the test is conducted. The final amount may depend upon the findings during the test procedure and post-operative care that is necessary (if any)

What is the Significance of the Molecular Testing for Extraskeletal Myxoid Chondrosarcoma Result?

The significance of Molecular Testing for Extraskeletal Myxoid Chondrosarcoma is explained:

  • Presence of a positive test result helps aid, and in some cases, confirm the diagnosis of extraskeletal myxoid chondrosarcoma
  • The result can help exclude other tumors with similar histological features
  • It can help determine the prognosis of the patient
  • In some cases, the test results may help in taking treatment decisions

The laboratory test results are NOT to be interpreted as results of a "stand-alone" test. The test results have to be interpreted after correlating with suitable clinical findings and additional supplemental tests/information. Your healthcare providers will explain the meaning of your tests results, based on the overall clinical scenario.

Additional and Relevant Useful Information:

  • Many laboratories may not have the capability to perform this test. Only highly-specialized labs with advanced facilities and testing procedures may perform this test
  • Additional mutations are still being discovered in many of these tumors. This may further contribute towards tumor diagnosis and treatment. Please consult with your healthcare provider for any information updates

Certain medications that you may be currently taking may influence the outcome of the test. Hence, it is important to inform your healthcare provider of the complete list of medications (including any herbal supplements) you are currently taking. This will help the healthcare provider interpret your test results more accurately and avoid unnecessary chances of a misdiagnosis.

What are some Useful Resources for Additional Information?

The following DoveMed website link is a useful resource for additional information:

http://www.dovemed.com/diseases-conditions/extraskeletal-myxoid-chondrosarcoma-emc/

Please visit our Laboratory Procedures Center for more physician-approved health information:

http://www.dovemed.com/common-procedures/procedures-laboratory/

References and Information Sources used for the Article:

https://ghr.nlm.nih.gov/primer/testing/genetictesting (accessed on 02/17/2017)

https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5806a1.htm (accessed on 02/17/2017)

http://www.nature.com/gim/journal/v10/n5/full/gim200852a.html (accessed on 02/17/2017)

http://pediatrics.aappublications.org/content/106/6/1494 (accessed on 02/17/2017)

http://atlasgeneticsoncology.org/Tumors/ExtraMyxChondroID5025.html (accessed on 02/17/2017)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1868116/ (accessed on 02/17/2017)

http://www.nature.com/modpathol/journal/v13/n8/full/3880161a.html (accessed on 02/17/2017)

Helpful Peer-Reviewed Medical Articles:

Carrano, A. V., et al. Measurement and purification of human chromosomes by flow cytometry and sorting. Proceedings of the National Academy of Sciences 76, 1382–1384 (1979)

Drets, M. E., & Shaw, M. W. Specific banding patterns of human chromosomes. Proceedings of the National Academy of Sciences 68, 2073–2077 (1971)

Druker, B. J. Perspectives on the development of a molecularly targeted agent. Cancer Cell 1, 31–36 (2002)

Parra, I., & Windle, B. High resolution visual mapping of stretched DNA by fluorescent hybridization. Nature Genetics 5, 17–21 (1993) doi:10.1038/ng0993-17

Pinkel, D., et al. High resolution analysis of DNA copy number variation using comparative genomic hybridization to microarrays. Nature Genetics 20, 207–211 (1998) doi:10.1038/2524

Speicher, M. R., et al. Karyotyping human chromosomes by combinatorial multi-fluor FISH. Nature Genetics 12, 368–375 (1996) doi:10.1038/ng0496-368

Gambarotti, M. (2014). Extraskeletal Myxoid Chondrosarcoma. In Atlas of Musculoskeletal Tumors and Tumorlike Lesions (pp. 377-379). Springer International Publishing.

Flucke, U., Tops, B. B., Verdijk, M. A., van Cleef, P. J., van Zwam, P. H., Slootweg, P. J., ... & Mentzel, T. (2012). NR4A3 rearrangement reliably distinguishes between the clinicopathologically overlapping entities myoepithelial carcinoma of soft tissue and cellular extraskeletal myxoid chondrosarcoma. Virchows Archiv, 460(6), 621-628.

Ogura, K., Fujiwara, T., Beppu, Y., Chuman, H., Yoshida, A., Kawano, H., & Kawai, A. (2012). Extraskeletal myxoid chondrosarcoma: a review of 23 patients treated at a single referral center with long-term follow-up. Archives of orthopaedic and trauma surgery, 132(10), 1379-1386.

Sawada, M., Tochigi, N., Sasajima, Y., Hasegawa, T., Kasamatsu, T., & Kitawaki, J. (2011). Primary extraskeletal myxoid chondrosarcoma of the vulva. Journal of Obstetrics and Gynaecology Research, 37(11), 1706-1710.

Demicco, E. G., Wang, W. L., Madewell, J. E., Huang, D., Bui, M. M., Bridge, J. A., & Meis, J. M. (2013). Osseous myxochondroid sarcoma: a detailed study of 5 cases of extraskeletal myxoid chondrosarcoma of the bone. The American journal of surgical pathology, 37(5), 752-762.

Kapoor, N., Shinagare, A. B., Jagannathan, J. P., Shah, S. H., Krajewski, K. M., Hornick, J. L., & Ramaiya, N. H. (2014). Clinical and radiologic features of extraskeletal myxoid chondrosarcoma including initial presentation, local recurrence, and metastases. Radiology and oncology, 48(3), 235-242.

Han, K., Sun, Y. J., Shen, Z., Zhang, J. J., Lin, F., Zhao, H., ... & Yao, Y. (2010). Extraskeletal myxoid chondrosarcoma: a case report of complete remission by chemotherapy and review of the literature. BMJ case reports, 2010, bcr0720092128.

Agaram, N. P., Zhang, L., Sung, Y. S., Singer, S., & Antonescu, C. R. (2014). Extraskeletal myxoid chondrosarcoma with non–EWSR1-NR4A3 variant fusions correlate with rhabdoid phenotype and high-grade morphology. Human pathology, 45(5), 1084-1091.

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: Feb. 28, 2017
Last updated: Feb. 28, 2017