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Son SM, Woo CG, Lee OJ, Kim YJ, Lee HC. Inflammatory myofibroblastic tumor of the urinary bladder with FN1‑ALK gene fusion: A case report. Oncol Lett 2023; 25:227. [PMID: 37153035 PMCID: PMC10157617 DOI: 10.3892/ol.2023.13813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/29/2023] [Indexed: 05/09/2023] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs), which are rare tumors, exhibit myofibroblastic differentiation, often with anaplastic lymphoma kinase (ALK) gene rearrangements. A subset of IMTs identified in the urinary tract have been shown to harbor a fibronectin 1 (FN1)-ALK gene fusion. In this case report, a case of an IMT with FN1-ALK fusion in the urinary bladder was presented, and its clinicopathological characteristics were reviewed. A 45-year-old female was referred to Chungbuk National University Hospital with gross hematuria. Cystoscopy revealed a solid mass in the bladder. The patient subsequently underwent transurethral resection of the lesion. The mass comprised stellate and spindled myofibroblastic cells that were arranged in loose fascicles, with a myxoid background and a mixed inflammatory infiltrate. Immunohistochemical analysis revealed that the tumor cells were positive for vimentin, cytokeratin AE1/AE3 and ALK, and focal-positive for desmin. Targeted next-generation sequencing was subsequently employed to identify the FN1-ALK fusion. To date, the patient has undergone outpatient follow-up for 18 months, with no signs of tumor recurrence. To conclude, in total, FN1 has been identified as an ALK fusion partner almost exclusively in cases of genitourinary IMTs [13 bladder IMTs (including the present case) and two uterine IMTs]. In the present case, the FN1-ALK fusion was found to involve ALK exon 19 and FN1 exon 23. By contrast, the majority of the other IMTs with an ALK fusion have involved ALK exon 20, whereas ALK fusion involving ALK exon 18 or 19 has been reported only in genitourinary IMTs. Therefore, the FN1-ALK fusion involving ALK exon 18 or 19 may be specific to a subset of IMTs arising in the urinary bladder.
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Affiliation(s)
- Seung-Myoung Son
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, North Chungcheong 28644, Republic of Korea
| | - Chang Gok Woo
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, North Chungcheong 28644, Republic of Korea
| | - Ok-Jun Lee
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, North Chungcheong 28644, Republic of Korea
| | - Yong June Kim
- Department of Urology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, North Chungcheong 28644, Republic of Korea
| | - Ho-Chang Lee
- Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, North Chungcheong 28644, Republic of Korea
- Correspondence to: Dr Ho-Chang Lee, Department of Pathology, Chungbuk National University Hospital, Chungbuk National University College of Medicine, 1 Chungdae-ro, Seowon, Cheongju, North Chungcheong 28644, Republic of Korea, E-mail:
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Pire A, Orbach D, Galmiche L, Berrebi D, Irtan S, Boudjemaa S, Brisse HJ, Berteloot L, Moalla S, Mussini C, Philippe-Chomette P, Tilea B, Pierron G, Guerin F, Minard-Colin V, Sarnacki S. Clinical, pathologic, and molecular features of inflammatory myofibroblastic tumors in children and adolescents. Pediatr Blood Cancer 2022; 69:e29460. [PMID: 34854544 DOI: 10.1002/pbc.29460] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 10/01/2021] [Accepted: 10/18/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Inflammatory myofibroblastic tumors (IMT) are rare, intermediate malignant tumors harboring frequent somatic molecular rearrangements. The management of IMT has not been standardized. METHODS A retrospective multicenter study was conducted on all pediatric patients treated for IMT between 2000 and 2019. RESULTS This series included 39 cases of IMT, with a median age at diagnosis of 7 years (range 20 days to 16 years). Tumor location included pelvis-abdomen (n = 16), thorax (n = 14), head and neck (n = 7), and limbs (n = 2). One patient had metastatic disease. Immunochemistry showed 21/39 (54%) anaplastic lymphoma kinase (ALK)-positive tumors. Somatic tyrosine kinase rearrangement was present in 31/36 (86%) of the tumors analyzed: 21 ALK, five ROS1, and five NTRK. Immediate surgery was performed in 24 patients (62%), with adjuvant therapy for three patients. Delayed surgery after neoadjuvant therapy was possible in 10 cases. Exclusive systemic therapy was delivered to four patients; one patient with orbital IMT was managed by watchful waiting. After a median follow-up of 33 months (range 5-124), eight (20%) recurrences/progressions occurred after surgery (seven after primary surgery and one after delayed surgery), after a median interval of 7 months (range 2-21), all in thoracic locations. The 3-year overall and disease-free survivals were 96.8% (95% CI: 79.2%-94.0%) and 77.4% (95% CI: 59.6%-88.1%), respectively. Relapses/progressions were more common in patients with a thoracic primary (p < .001) or after incomplete surgery with no adjuvant therapy (p = .027). CONCLUSION Surgery is effective in most cases of pediatric IMT. Systematic analysis of tyrosine kinase rearrangement is recommended. When the tumor is deemed only partially resectable to preserve organs and function, neoadjuvant therapy may be proposed to allow adequate conservative surgery.
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Affiliation(s)
- Aurore Pire
- Department of Paediatric Surgery and Abdominal Transplantation, ,Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Daniel Orbach
- SIREDO Oncology Center (Care, Innovation and Research for Children and AYA with Cancer), PSL Research University, Institut Curie, Paris, France
| | - Louise Galmiche
- Department of pathology, University Hospital of Nantes, Nantes, France
| | | | - Sabine Irtan
- Department of Paediatric Surgery, Hopital Armand Trousseau, Paris, France
| | - Sabah Boudjemaa
- Department of Pathology, Hopital Armand Trousseau, Paris, France
| | | | | | - Salma Moalla
- Department of Imaging, Institut Gustave Roussy, Paris, France
| | - Charlotte Mussini
- Department of Pathology, Hopital Kremlin Bicêtre, Pathology, Paris, France
| | | | - Bogdana Tilea
- Department of Imaging, Hopital Robert Debré, Paris, France
| | - Gaelle Pierron
- Institut Curie, Unité de Génétique Somatique, Paris, France
| | - Florent Guerin
- Department of Paediatric Surgery, Hôpital Kremlin Bicêtre, Paris, France
| | - Véronique Minard-Colin
- Department of Paediatric and Adolescent Oncology, INSERM U1015, Gustave Roussy, Université Paris-Saclay, Villejuif, France
| | - Sabine Sarnacki
- Department of Paediatric Surgery, Hôpital Universitaire Necker-Enfants Malades, Université de Paris, Paris, France
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Sanaya SZ, Matsneva IA, Redkina NA, Telezhnikova IM, Magnaeva AS, Tregubova AV, Asaturova AV, Kometova VV. [Immunohistochemical and molecular diagnosis of inflammatory myofibroblastic tumor of the uterus: a literature review and a clinical case]. Arkh Patol 2021; 83:43-48. [PMID: 34609804 DOI: 10.17116/patol20218305143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Inflammatory myofibroblastic tumors of the uterus (uIMT) are rare and difficult to diagnose neoplasms, since the morphological characteristics of this tumor are not specific and are found in other pathological changes. In addition, until recently, specific uIMT markers have not been identified and their diagnostic standards not defined. However, in recent years, there have been more and more studies aimed to identify characteristic morphological, immunohistochemical, and molecular genetic features for the differential diagnosis of uIMT. Recent papers studying uIMT indicate anaplastic lymphoma kinase (ALK) as a potentially reliable marker of uIMT. This communication describes a clinical case of uIMT in a 40-year-old woman who has been preoperatively diagnosed with a large subserous interstitial myomatous nodule. The final diagnosis was made, by analysing a combination of morphological and immunohistochemical signs. This clinical case with a literature review is indicated to consider ALK as a key criterion in the diagnosis of uIMT, as well as the relationship between subsequent treatment and the presence of ALK in the studied tissues.
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Affiliation(s)
- S Z Sanaya
- A.I. Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - I A Matsneva
- I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - N A Redkina
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia, Moscow, Russia
| | - I M Telezhnikova
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia, Moscow, Russia
| | - A S Magnaeva
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia, Moscow, Russia
| | - A V Tregubova
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia, Moscow, Russia
| | - A V Asaturova
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia, Moscow, Russia
| | - V V Kometova
- Academician V.I. Kulakov National Medical Research Center of Obstetrics, Gynecology and Perinatology of the Ministry of Health of Russia, Moscow, Russia
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Cheng KJ, Wang SQ, Zhou SH. A case report of an inflammatory myofibroblastic tumor of the neck: A focus on the computed tomography and magnetic resonance imaging findings. Oncol Lett 2015; 10:518-522. [PMID: 26171061 DOI: 10.3892/ol.2015.3168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2014] [Accepted: 04/09/2015] [Indexed: 11/06/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) of the neck are rare, with only a few patients reported in the literature. The present study discusses the clinical manifestations, radiographic characteristics and management of these tumors, with a focus on imaging modalities. A case of IMT of the neck is presented and the associated literature is reviewed. In total, seven patients in seven English-language studies, including the present case, and one patient in one Chinese-language study were found. On CT scans, all tumors appeared as soft-tissue densities. Upon magnetic resonance imaging (MRI), all tumors displayed a heterogeneous hypointense-isointense signal on T1-weighted sequences and an isointense-hyperintense signal on T2-weighted sequences. All tumors showed enhancement on enhanced CT and MR images. The imaging features of the neck IMTs can be summarized as follows: i) When enhanced, the tumor displays enhancement on CT and MR images; ii) MRI is superior to CT scans in the differential diagnosis of this disease; iii) in general, the lesion displays a hypointense-isointense signal on T1-weighted sequences and an isointense-hyperintense signal on T2-weighted sequences; iv) due to the fibrous tissue in the tumor, delayed enhancement may be observed on gadolinium-enhanced MR images; and v) due to its benign or intermediate features, the tumor is usually a well-defined mass.
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Affiliation(s)
- Ke-Jia Cheng
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shen-Qing Wang
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Shui-Hong Zhou
- Department of Otolaryngology, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
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Pecoraro Y, Diso D, Anile M, Russo E, Patella M, Venuta F. Primary inflammatory myofibroblastic tumor of the trachea. Respirol Case Rep 2014; 2:147-9. [PMID: 25530866 PMCID: PMC4263498 DOI: 10.1002/rcr2.81] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Revised: 08/19/2014] [Accepted: 08/26/2014] [Indexed: 12/05/2022] Open
Abstract
Inflammatory myofibroblastic tumors (IMTs) are rare neoplasms that can involve the airway. Recent studies have shown their malignant behavior with local recurrence and potential metastatic spread; half of the cases are associated with anaplastic lymphoma kinase gene rearrangement. Complete surgical resection is recommended, when feasible. We present a case of a 26-year-old woman admitted to our institution with severe respiratory failure; she was affected with primary IMT of the trachea and underwent complete surgical resection.
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Affiliation(s)
- Ylenia Pecoraro
- Department of Thoracic Surgery, University of Rome "Sapienza" Rome, Italy
| | - Daniele Diso
- Department of Thoracic Surgery, University of Rome "Sapienza" Rome, Italy
| | - Marco Anile
- Department of Thoracic Surgery, University of Rome "Sapienza" Rome, Italy
| | - Emanuele Russo
- Department of Thoracic Surgery, University of Rome "Sapienza" Rome, Italy
| | - Miriam Patella
- Department of Thoracic Surgery, University of Rome "Sapienza" Rome, Italy
| | - Federico Venuta
- Department of Thoracic Surgery, University of Rome "Sapienza" Rome, Italy ; Fondazione Eleonora Lorillard Spencer Cenci Rome, Italy
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