ECP 2022 Abstract Book

Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 thyroid carcinoma. The main survival time for 3 patients varied from 1to 8 months. The other patients were lost. Conclusion: Mature teratoma with malignant transformation are rare aggressive tumours that mostly occurs in post-menopausal age. It is characterized by a late stage diagnosis and poor outcome. Treatment is based on surgery and radio-chemotherapy. Immuno- therapy and target therapy has been recently introduced to reduce mortality. The overall goals of management are palliation of symp- toms, preventing recurrence or spread of disease and preservation of fertility. E-PS-09-003 Expression of autophagy markers in ovarian cancer L. Jovanovic*, A. Nikolić, S. Dragicevic, M. Jović, R. Janković *Department of Human Reproduction, Faculty of Medicine, Uni- versity of Belgrade, Serbia Background & objectives: Autophagy is a crucial cellular mechanism that coordinates various physiological processes. Many cancers can activate autophagy and make the tumour more aggressive. In this study, we analysed autophagy in ovarian cancers. Methods: We included 122 patients with ovarian cancers. Tissue microarray was made for immunohistochemical analysis of p62, LC3, and Beclin1 expressions. Their expressions were correlated with tumour histology type, differentiation, and stage. The percentage of positive tumour cells was estimated from the total number of tumour cells. Samples with positive cells were stratified into three ranges of positivity: <10%; 10–50%; >50%. Results: There was a strong positive correlation between p62 and LC3 expression, while both markers were in negative correlation with Beclin1. The expression of each analysed marker showed a statistically significant association with tumour histological type, stage, and differentiation (p<0.001). While p62 and LC3 were more prominently expressed in patients with high-grade serous ovarian cancer (HGSOC), Beclin 1 expression was lower in HGSOC and more prominent in other histology types. A higher expression of p62 and LC3 was observed in later tumour stages, while the oppo- site was observed for Beclin1 expression. Tumour differentiation positively correlated with p62 and LC3 expression, and negatively with Beclin1 expression. Conclusion: The expression of p62 and LC3 was more promi- nent in HGSOC in comparison to other histology types, while Beclin1 expression was more prominent in carcinomas other than in HGSOC. While p62 and LC3 expression was associated with higher tumour stages and tumour grades, the opposite was found for Beclin1. Prominent p62 and LC3 expression in combination with weak Beclin1 expression in HGSOC indicate the potential for application of autophagy inhibitors in patients with this tumour subtype. E-PS-09-004 Expanding the spectrum of GLI1-activated mesenchymal tumours – a high-grade uterine sarcoma harbouring a novel PAMR1-GLI1 fusion L.S. Punjabi*, R.C.H. Goh, K. Sittampalam *Department of Anatomical Pathology, Singapore General Hos- pital, Singapore Background & objectives: GLI1-activated mesenchymal tumours comprise a group of seemingly unrelated entities, including pericy- toma with t(7;12) translocation, plexiform fibromyxoma, gastroblas- toma, malignant epithelioid neoplasm with GLI1 rearrangements and GLI1-amplified mesenchymal neoplasms. Herein we report an unusual GLI1-rearranged uterine sarcoma. Methods: Clinical history: A 57-year-old female presented with an abdomino-pelvic mass. MRI showed a myometrial mass extending beyond the serosa, with features of peritoneal involvement. The patient underwent onco- logic resection. Gross examination revealed a perforated multi-nod- ular uterine tumour (21cm) with a firm white and soft fleshy cut surface, featuring haemorrhage and necrosis. An omental deposit (9cm) also displayed similar appearance. Results: Histopathology: The tumour was morphologically heterogenous, disclosing frankly sarcomatous areas composed of pleomorphic spindle and focally epithelioid cells, intermingled with a component of monomorphic spindle cells arranged in fascicles. There was a rich vascular network and zones of necrosis with peripheral amianthoid-like collagen plaques. Lymphovascular invasion and metastasis to lymph nodes and omentum were identified. The tumour was immunopositive for CD10 and cyclinD1, and negative for MNF116, ER, p16, CD117, DOG1, S100, smooth muscle and melanotic markers. ArcherTM Fusion Sarcoma Assay detected PAMR1(exon1)-GLI1(exon4) fusion, confirmed on RT-PCR and Sanger sequencing. The patient received adjuvant chemo- radiotherapy however developed metastatic recurrence and demised 18 months post-surgery. Conclusion: To the best of our knowledge, this forms the third report of GLI1-rearranged uterine sarcoma. Previous reports showed low-grade epithelioid morphology and harboured canonical fusions (ACTB-GLI1, PTCH1-GLI1). In contrast, this case shows high grade, predominantly spindled morphology and harbours a novel fusion, PAMR1-GLI1. The precise classification of these tumours, and their relation to other uterine sarcomas with high GLI1 expression, including a subset of HG-ESS and LMS, remain uncertain. Emerging GLI/Hedgehog inhibitors provide clinical rel- evance to recognising these tumours. E-PS-09-005 Cervical carcinosarcoma: a rare case report S. Reis*, N. Castelo-Branco, C. Caramujo, R. Marques, G. Sousa, P. Figueiredo *Department of Pathology, Instituto Português de Oncologia de Coimbra Francisco Gentil EPE, Portugal Background & objectives: Uterine carcinosarcoma is an aggressive biphasic malignant neoplasm, composed of epithelial and mesenchymal elements. Cervical carcinosarcoma (CCS) is exceptionally rare with less than 70 cases described in the English literature. Methods: We present a case of a 63-year-old woman with a sud- den episode of high volume serous vaginal discharge. On physical examination there was a 5 cm exophytic flat friable mass in the cervix. A pelvic magnetic resonance imaging (MRI) showed an expansive lesion with 70x50x56mm in the endocervical canal that did not invade the uterine body. Results: The biopsy revealed a malignant neoplasm with a pre- dominant sarcomatous component without a specific morphologi- cal differentiation, and less than 5% of squamous cell carcinoma. Immunohistochemistry revealed positivity for cytokeratins (AE1- AE3; 34BE12; CK 8/18) and EMA in the squamous component; CK8/18 was heterogeneously positive in the sarcomatous component and p16 was diffusely positive in both components. Accordingly, the proposed diagnosis was cervical carcinosarcoma with homologous mesenchymal component. The patient was submitted to radical sur- gery and the final post-operative staging was FIGO (2018): IB3. Due to surgical complications adjuvant treatment was not performed. S256