Mobilization of tumour cells during biopsy in an infant with Ewing sarcoma
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Ewing sarcoma and the closely relate peripheral primitive neuroectodermal tumour, recently referred to as Ewing tumour (ET), are characterised by unique gene rearrangements on chromosome 22. The breakpoints have been cloned and shown to fuse the Ewing sarcoma gene to one of two closely related ETS proto-oncogens, FLI-1 or ERG, which reside on chromosomes 11 and 21, respectively. The rearrangement results in the expression of specific hybrid transcripts which can be detected with high sensitivity by the reverse transcriptase polymerase chain reaction technique (RT-PCR) in primary tumours, blood and bone marrow. We report on a 7-month-old boy with a pelvic Ewing sarcoma in whom circulating tumour cells were identified in the peripheral blood during open tumour biopsy by RT-PCR. However, before and 6 days after surgery no tumour cells could be detected in the peripheral blood.
The application of RTPCR to monito shedding of tumour cells during surgical intervention will nelp to evaluate if open biopsy potentially contributes to metastatic tumour cell spread.
Key wordsEwing tumours EWS-FLI-1 fusion transcripts Circulating tumour cells Tumour biopsy Minimal metastatic disease
complementary desoxyribonucleic acid
- ETS E26
avian erythroblastosis virus transformation-specific oncogen
- EWS gene
Ewing sarcoma gene
- FLI-1 gene
Friend leukaemia virus integration site 1 gene
cell surface sialoglycoprotein
messanger ribonucleic acid
reverse transcriptasepolymerase chain reaction
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