Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics

ALK rearrangements are rarely documented in superficial soft tissue neoplasms exhibiting an infantile fibrosarcoma-like spindle cell tumor (IFS) pattern or stromal, resembling Neurotrophic Tyrosine Kinase Receptor(NTRK)rearranged spindle cell tumors. Here, we present two cases of pediatric cutaneous...

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Main Authors: Qi Ouyang, Xiaohong Guo, Rongjun Mao, Zhixing Cao
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Oncology
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Online Access:https://www.frontiersin.org/articles/10.3389/fonc.2025.1516491/full
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author Qi Ouyang
Xiaohong Guo
Rongjun Mao
Zhixing Cao
author_facet Qi Ouyang
Xiaohong Guo
Rongjun Mao
Zhixing Cao
author_sort Qi Ouyang
collection DOAJ
description ALK rearrangements are rarely documented in superficial soft tissue neoplasms exhibiting an infantile fibrosarcoma-like spindle cell tumor (IFS) pattern or stromal, resembling Neurotrophic Tyrosine Kinase Receptor(NTRK)rearranged spindle cell tumors. Here, we present two cases of pediatric cutaneous soft tissue tumors with an IFS pattern, in which ALK fusions involving related partner genes were identified. The tumors in both cases demonstrated similar morphology and consisted of ovoid and spindle cells with infiltrative boundaries. The spindle cells exhibited either a fascicular growth pattern or a haphazard pattern and stromal hyalinization. Both cases involved inflammatory cell infiltration, brisk mitosis, and CD34, S100, and ALK-D5F3 immunoreactivity. Next-generation sequencing identified ALK fusion with different partner genes (STRN and PLEKHH2). The fluorescence in situ hybridization break-apart assay confirmed ALK rearrangements in both cases. In case 1, no indications of disease progression or metastasis was observed within the limited follow-up (36 months). However, the patient in case 2 experienced a rapid recurrence and metastasis.
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publisher Frontiers Media S.A.
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series Frontiers in Oncology
spelling doaj-art-c98ccb46ac2b4e8198dbf78a1fb60a1c2025-08-20T03:22:18ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-05-011510.3389/fonc.2025.15164911516491Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristicsQi Ouyang0Xiaohong Guo1Rongjun Mao2Zhixing Cao3Department of Pathology, Zhuhai People’s Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, Guangdong, ChinaDepartment of Pathology, Zhuhai People’s Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, Guangdong, ChinaDepartment of Pathology, Foshan Hospital of Traditional Chinese Medicine, Foshan, Guangdong, ChinaDepartment of Pathology, Zhuhai People’s Hospital (Zhuhai Clinical Medical College of Jinan University), Zhuhai, Guangdong, ChinaALK rearrangements are rarely documented in superficial soft tissue neoplasms exhibiting an infantile fibrosarcoma-like spindle cell tumor (IFS) pattern or stromal, resembling Neurotrophic Tyrosine Kinase Receptor(NTRK)rearranged spindle cell tumors. Here, we present two cases of pediatric cutaneous soft tissue tumors with an IFS pattern, in which ALK fusions involving related partner genes were identified. The tumors in both cases demonstrated similar morphology and consisted of ovoid and spindle cells with infiltrative boundaries. The spindle cells exhibited either a fascicular growth pattern or a haphazard pattern and stromal hyalinization. Both cases involved inflammatory cell infiltration, brisk mitosis, and CD34, S100, and ALK-D5F3 immunoreactivity. Next-generation sequencing identified ALK fusion with different partner genes (STRN and PLEKHH2). The fluorescence in situ hybridization break-apart assay confirmed ALK rearrangements in both cases. In case 1, no indications of disease progression or metastasis was observed within the limited follow-up (36 months). However, the patient in case 2 experienced a rapid recurrence and metastasis.https://www.frontiersin.org/articles/10.3389/fonc.2025.1516491/fullcase reportcutaneousspindle tumorinfantile fibrosarcoma-like tumorALK rearrangement
spellingShingle Qi Ouyang
Xiaohong Guo
Rongjun Mao
Zhixing Cao
Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics
Frontiers in Oncology
case report
cutaneous
spindle tumor
infantile fibrosarcoma-like tumor
ALK rearrangement
title Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics
title_full Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics
title_fullStr Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics
title_full_unstemmed Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics
title_short Case Report: ALK-rearranged mesenchymal neoplasms with S100 and CD34 co-expression: additional cases with distinct characteristics
title_sort case report alk rearranged mesenchymal neoplasms with s100 and cd34 co expression additional cases with distinct characteristics
topic case report
cutaneous
spindle tumor
infantile fibrosarcoma-like tumor
ALK rearrangement
url https://www.frontiersin.org/articles/10.3389/fonc.2025.1516491/full
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AT rongjunmao casereportalkrearrangedmesenchymalneoplasmswiths100andcd34coexpressionadditionalcaseswithdistinctcharacteristics
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