Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung
Abstract Background Inflammatory myofibroblastic tumor (IMT) of the lung is rare. This disease often shows neoplastic features with anaplastic lymphoma kinase positiveness as well as inflammatory features, such as steroid-responsive immunoglobulin G4 (IgG4)-related sclerosing disease. Since many cas...
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| Format: | Article |
| Language: | English |
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Japan Surgical Society
2019-07-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-019-0674-x |
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| author | Hironosuke Watanabe Naoya Yamasaki Takuro Miyazaki Keitaro Matsumoto Tomoshi Tsuchiya Kuniko Abe Takeshi Nagayasu |
| author_facet | Hironosuke Watanabe Naoya Yamasaki Takuro Miyazaki Keitaro Matsumoto Tomoshi Tsuchiya Kuniko Abe Takeshi Nagayasu |
| author_sort | Hironosuke Watanabe |
| collection | DOAJ |
| description | Abstract Background Inflammatory myofibroblastic tumor (IMT) of the lung is rare. This disease often shows neoplastic features with anaplastic lymphoma kinase positiveness as well as inflammatory features, such as steroid-responsive immunoglobulin G4 (IgG4)-related sclerosing disease. Since many cases have been reported as advanced, various treatment strategies should be considered based on clinical and biological features of each case. Case presentation We report a 49-year-old male with IMT, which seemed invading the left atrium from preoperative imaging modalities. Serological and pathological examinations from the biopsy specimen revealed high expression of anaplastic lymphoma kinase expression in the tumor. On the other hand, IgG4/IgG ration in the tumor was small, where a therapeutic effect of steroid was not expected, leading to surgical treatment rather than a steroid administration. The tumor was completely resected en bloc with the right lower lobe of the lung and a part of the left atrium. The postoperative course of the patient was uneventful. The patient has remained recurrence free over 5 years from the surgery. Conclusion In this case, preoperative biological assessment prior to the treatment led to a good clinical course. We believe that molecular biological examination is important in the determination of treatment strategy for this rare disease as well as imaging modalities. |
| format | Article |
| id | doaj-art-68146e134e624ac28a862bbb625f8caa |
| institution | Kabale University |
| issn | 2198-7793 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-68146e134e624ac28a862bbb625f8caa2025-08-20T03:33:54ZengJapan Surgical SocietySurgical Case Reports2198-77932019-07-01511410.1186/s40792-019-0674-xSuccessful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lungHironosuke Watanabe0Naoya Yamasaki1Takuro Miyazaki2Keitaro Matsumoto3Tomoshi Tsuchiya4Kuniko Abe5Takeshi Nagayasu6Division of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical SciencesDivision of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical SciencesDivision of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical SciencesDivision of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical SciencesDivision of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical SciencesDepartment of Pathology, Nagasaki University Graduate School of Biomedical SciencesDivision of Surgical Oncology, Department of Surgery, Nagasaki University Graduate School of Biomedical SciencesAbstract Background Inflammatory myofibroblastic tumor (IMT) of the lung is rare. This disease often shows neoplastic features with anaplastic lymphoma kinase positiveness as well as inflammatory features, such as steroid-responsive immunoglobulin G4 (IgG4)-related sclerosing disease. Since many cases have been reported as advanced, various treatment strategies should be considered based on clinical and biological features of each case. Case presentation We report a 49-year-old male with IMT, which seemed invading the left atrium from preoperative imaging modalities. Serological and pathological examinations from the biopsy specimen revealed high expression of anaplastic lymphoma kinase expression in the tumor. On the other hand, IgG4/IgG ration in the tumor was small, where a therapeutic effect of steroid was not expected, leading to surgical treatment rather than a steroid administration. The tumor was completely resected en bloc with the right lower lobe of the lung and a part of the left atrium. The postoperative course of the patient was uneventful. The patient has remained recurrence free over 5 years from the surgery. Conclusion In this case, preoperative biological assessment prior to the treatment led to a good clinical course. We believe that molecular biological examination is important in the determination of treatment strategy for this rare disease as well as imaging modalities.http://link.springer.com/article/10.1186/s40792-019-0674-xInflammatory myofibroblastic tumorAnaplastic lymphoma kinaseImmune globulin G 4-related sclerosing disease |
| spellingShingle | Hironosuke Watanabe Naoya Yamasaki Takuro Miyazaki Keitaro Matsumoto Tomoshi Tsuchiya Kuniko Abe Takeshi Nagayasu Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung Surgical Case Reports Inflammatory myofibroblastic tumor Anaplastic lymphoma kinase Immune globulin G 4-related sclerosing disease |
| title | Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung |
| title_full | Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung |
| title_fullStr | Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung |
| title_full_unstemmed | Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung |
| title_short | Successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase-positive inflammatory myofibroblastic tumor of the lung |
| title_sort | successful treatment based on molecular biological assessment of invasive anaplastic lymphoma kinase positive inflammatory myofibroblastic tumor of the lung |
| topic | Inflammatory myofibroblastic tumor Anaplastic lymphoma kinase Immune globulin G 4-related sclerosing disease |
| url | http://link.springer.com/article/10.1186/s40792-019-0674-x |
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