Anaplastic lymphoma kinase-positive pulmonary inflammatory myofibroblastic tumour: a case report

J Med Case Rep. 2024 Apr 10;18(1):167. doi: 10.1186/s13256-024-04472-9.

Abstract

Background: Pulmonary inflammatory myofibroblastic tumour (IMT) is a rare condition that usually presents in young individuals and is associated with anaplastic lymphoma kinase (ALK)-translocation.

Case presentation: We report a case of an 18-year-old Caucasian man with ALK-translocated pulmonary IMT treated with multimodality therapy. The patient presented with breathlessness and was found to have a collapsed left lung. Further investigations revealed an ALK-translocated pulmonary IMT. This is usually treated with an ALK-inhibitor but patient declined after discussing potential side-effects and had repeated rigid bronchoscopic interventions for local disease control. Due to persistent local recurrence, patient received radical external beam radiotherapy (EBRT) with pulse steroids, and one year later started on Ibuprofen, a non-steroidal anti-inflammatory agent (NSAID). Following multimodality treatment, he developed a complete response. He remains treatment-free for the past seven years. Eleven years on from his diagnosis, he remains in remission with a ECOG performance status of zero.

Conclusions: Achieving long-term local control in pulmonary IMT can be challenging. Multimodality treatment is sometimes needed but the overall outlook remains good.

Keywords: ALK; Long-term remission; Multimodality; Pulmonary inflammatory myofibroblastic tumour; Radiotherapy and pulse steroids.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Anaplastic Lymphoma Kinase / genetics
  • Humans
  • Male
  • Neoplasms*
  • Pathologic Complete Response
  • Protein Kinase Inhibitors* / therapeutic use
  • Translocation, Genetic

Substances

  • Anaplastic Lymphoma Kinase
  • Protein Kinase Inhibitors