Mammary-type myofibroblastoma with infarction and atypical mitosis-a potential diagnostic pitfall: A case report.

BACKGROUND: Mammary-type myofibroblastoma (MTMF) is a rare benign extramammary soft tissue tumor with myofibroblastic differentiation. Although 160 cases of MTMF have been reported in the literature since 2001, no cases of infarction or atypical mitosis have been reported so far. Herein, we report an unusual case of MTMF in the pelvic cavity, which mimicked some malignant features, including infarction, atypical mitosis, infiltrative growth, and prominent cytologic atypia, making it difficult to ascertain whether the tumor was benign. CASE SUMMARY: A 49-year-old man complained of pain and discomfort in the right buttock for more than 4 mo and did not receive any treatment. Nuclear magnetic resonance imaging (MRI) showed a 13-cm-sized mass in his right pelvic cavity. Histologically significant differences were atypical mitosis figures and multiple necrotic foci in the tumor. In addition, smooth muscle and skeletal muscle were invaded within and at the edge of the tumor. These morphologic features are often reminiscent of malignant tumors and therefore pose a diagnostic challenge to pathologists. The tumor cells were strongly positive for both cluster of differentiation 34 and desmin, and the loss of retinoblastoma 1 shown by immunohistochemical and fluorescence in situ hybridization results confirmed the pathological diagnosis of MTMF. Currently, the patient is alive and in good condition without tumor recurrence or metastasis after 2.5 years of follow-up by telephone and MRI. CONCLUSION: The two pseudo-malignant characteristics of infarction and atypical mitosis broaden the morphological lineage of MTMF, a rare mesenchymal tumor.

CircFADS2: A potential prognostic biomarker of colorectal cancer.

IMPACT STATEMENT: Colorectal cancer (CRC) is the third most common malignancy worldwide with the second highest mortality rate. Although multidisciplinary cooperative therapies are helpful for improving the survival of CRC patients, the prognosis remains poor. Therefore, it is imperative to seek new biomarkers for the development of individualized treatment for each CRC patient. Circular RNA, an endogenous transcript with specific covalent closed loop, exhibits higher stability, conservation and expression abundance than the corresponding linear component and thus may be utilized as a promised biomarker. Although the majority of studies have focused on circular RNA expression profiling in various types of cancers, evidence supporting their critical role in the diagnosis and prognosis of CRC is limited. This study aimed to screen and identify novel circular RNA biomarkers of CRC by chip analysis and qPCR verification, and to highlight their potential as targets for CRC prognosis, and therapy.

Formin-like 3 regulates RhoC/FAK pathway and actin assembly to promote cell invasion in colorectal carcinoma.

AIM: To clarify the underlying mechanism of formin-like 3 (FMNL3) in the promotion of colorectal carcinoma (CRC) cell invasion. METHODS: The in vitro biological function analyses of FMNL3 were performed by gain- and loss-of function approaches. Changes in the F-actin cytoskeleton were detected by the technologies of phalloidin-TRITC labeling and confocal microscopy. The signaling pathway mediated by FMNL3 was explored by western blot, gelatin zymograph assay, co-immunoprecipitation (co-IP), immunofluorescence co-localization, and glutathione S-transferase (GST) pull-down assay. RESULTS: The in vitro experimental results showed that FMNL3 significantly promoted the proliferation, invasion, and migration of CRC cells (P < 0.05 and P < 0.01). Moreover, FMNL3 regulated the remodeling of actin-based protrusions such as filopodia and lamellipodia in a RhoC-dependent manner. The western blot and gelatin zymograph assay results indicated that FMNL3 was involved in the RhoC/ focal adhesion kinase (FAK) pathway and acted as an effector of RhoC to activate the downstream signaling of p-FAK as well as p-MAPK and p-AKT. This resulted in the increased expression of matrix metalloproteinase 2 (MMP2), matrix metalloproteinase 9 (MMP9) and vascular endothelial growth factor (VEGF), and the subsequent promotion of CRC cell invasion. The results of TAE226, U0126 or Ly294002 treatment confirmed an essential role of FMNL3 in activation of the RhoC/FAK pathway and the subsequent promotion of CRC invasion. Co-IP, co-localization and GST pull-down assays showed the direct interaction of FMNL3 with RhoC in vivo and in vitro. CONCLUSION: FMNL3 regulates the RhoC/FAK signaling pathway and RhoC-dependent remodeling of actin-based protrusions to promote CRC invasion.

Increased expression of formin-like 3 contributes to metastasis and poor prognosis in colorectal carcinoma.

Formin-like 3 (FMNL3), a member of diaphanous-related formins subfamily, plays an important role in cytoskeleton reorganization, cell adhesion and cancer cell invasion in vitro. This study aimed to explore the expression of FMNL3 in colorectal carcinoma (CRC) cell-lines and tissues, and further evaluate its prognostic value and correlation with the clinicopathological parameters, and also investigate the effects of FMNL3 gene silencing on the growth and metastasis of CRC in vivo. Immunohistochemical analysis showed that FMNL3 protein was distributed in a punctuate aggregation pattern and located mainly in the cytoplasm of glandular cavity side, close to the nucleus of CRC cells. The positive rate of FMNL3 expression was 87.5% (84/96) in CRC, which was significantly higher than that in adjacent normal mucosa (30%, 9/30). Moreover, FMNL3 protein expressed far more in primary CRC with metastasis and corresponding lymph nodes metastatic CRC than in primary CRC without metastasis. Increased expression of FMNL3 was closely correlated with tumor size, differentiation, serosal invasion, and both lymph node metastasis and distant metastasis. However, it was not correlated with patients' age and gender. According to Kaplan-Meier survival analyses, patients with FMNL3 high expression level had lower overall survival rate than that with FMNL3 low expression level. Univariate and multivariate analyses revealed that high FMNL3 expression was a significant and independent prognostic predictor of patients with CRC. In addition, FMNL3 mRNA and protein levels were substantially up-regulated in CRC-metastasis-derived cell lines, as compared to those in primary-CRC-derived ones. FMNL3 gene silencing suppressed the growth and metastasis of CRC in vivo. In conclusion, FMNL3 plays an important role in the progression and metastasis of CRC and may be a novel potential prognostic predictor and therapeutic target for patients with CRC.

FMNL2 is a positive regulator of cell motility and metastasis in colorectal carcinoma.

FMNL2 is a member of diaphanous-related formins which act as effectors of Rho family GTPases and control the actin-dependent processes such as cell motility or invasion. We previously found that FMNL2 overexpression in metastatic cell lines and tissues of colorectal carcinoma is associated with more aggressive tumour behaviour. Here we used gain-of-function and loss-of-function approaches to investigate the effects of FMNL2 on colorectal carcinoma in vitro and in vivo. Forced expression of FMNL2 caused a significant increase in tumour cell proliferation, motility, invasion in vitro, and metastasis in vivo, whereas FMNL2 depletion showed opposite effects. We examined gene expression profiles following knockdown of FMNL2 in SW480/M5 cells. Expression of 323 genes was up-regulated by more than two-fold, whereas 222 genes were down-regulated by more than two-fold in FMNL2-depleting SW480/M5 cells. Gene ontology analysis showed that most of genes belong to functional categories such as cell cycle, cytoskeleton, transcription factor, and G-protein modulator. Pathway analysis revealed that cytoskeletal regulation by the Rho GTPase pathway, the Wnt pathway, the G-protein pathway, and the P53 pathway were affected by FMNL2. Many of these genes are in functional networks associated with cell proliferation, metastasis, Wnt or the Rho signalling pathway involved in the regulation of FMNL2. The expression of five differentially expressed genes including CXXC4, CD200, VAV1, CSF1, and EPHA2 was validated by real-time PCR and western blot analysis. Thus, FMNL2 is a positive regulator of cell motility, invasion, and metastasis of colorectal carcinoma.