A case of inflammatory myofibroblastic tumor harboring EML4-ALK fusion with a brain metastasis responding to alectinib

Thorac Cancer. 2024 Feb;15(5):415-418. doi: 10.1111/1759-7714.15203. Epub 2024 Jan 11.

Abstract

Metastatic inflammatory myofibroblastic tumor (IMT) is very rare and detailed reports on diagnosis and treatment are limited. Here, we report a case of metastatic IMT with ALK rearrangement. A 73-year-old woman was diagnosed with IMT involving a brain metastasis. Next generation sequencing (NGS) panel testing with Oncomine dx target test revealed that her tumor was positive for EML4-ALK. Treatment with alectinib was initiated, resulting in remarkable shrinkage of both the primary tumor and the brain metastasis. This report is the first to identify ALK rearrangement in IMT using a commercially available NGS panel testing, followed by treatment with alectinib. This case suggests that NGS panel testing may be useful in the diagnosis and treatment of patients with metastatic IMT.

Keywords: alectinib; brain metastasis; inflammatory myofibroblastic tumor; next-generation sequencing panel testing.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anaplastic Lymphoma Kinase / genetics
  • Brain Neoplasms* / drug therapy
  • Brain Neoplasms* / genetics
  • Brain Neoplasms* / secondary
  • Carbazoles / therapeutic use
  • Female
  • Granuloma, Plasma Cell* / pathology
  • Humans
  • Oncogene Proteins, Fusion / genetics
  • Piperidines / therapeutic use

Substances

  • Anaplastic Lymphoma Kinase
  • alectinib
  • Piperidines
  • Carbazoles
  • EML4-ALK fusion protein, human
  • Oncogene Proteins, Fusion