Benign peripheral nerve tumors include schwannoma, neurofibroma and perineurioma, as well as a recently recognized group of tumors with dual patterns of differentiation. The molecular pathogenesis of these so-called ‘hybrid’ tumors remains poorly understood. Following identification of a novel
CHD7-VGLL3
fusion gene in a hybrid schwannoma-perineurioma, we evaluated an expanded cohort of this tumor-type – as well as tumors with
VGLL3
rearrangement identified from a curated molecular database – to characterize the prevalence of fusion genes among these tumors. Eighteen tumors met the inclusion criteria for this study. RNA sequencing identified
VGLL3
rearrangement in 14 of these cases; the partner genes included
CHD7
(ten cases),
CHD9
(two cases), and
MAMLD1
(two cases). Two cases possessed altogether unrelated fusions, including:
DST-BRAF
and
SQSTM1-CDX1
fusion genes. Finally, two cases lacked identifiable fusion products. These findings highlight the molecular diversity of these neoplasms, with frequent rearrangement of
VGLL3
. More importantly, despite their dual pattern of differentiation, our results reveal the pathogenesis of hybrid schwannoma-perineurioma is unrelated to conventional schwannoma and perineurioma, thereby implying this tumor represents an altogether pathologically distinct entity.