Epithelioid inflammatory myofibroblastic sarcoma with recurrence after extensive resection: significant clinicopathologic characteristics of a rare aggressive soft tissue neoplasm

Int J Clin Exp Pathol. 2015 May 1;8(5):5803-7. eCollection 2015.

Abstract

A case of epithelioid inflammatory myofibroblastic scarcoma (EIMS) developing in an 8-year-old boy who presented with a bulky intra-abdominal occupying lesion with recurrence undergoing a radical resection was reported. Histologically, the tumor cells arranged in cords, strands or sheets of round-to-epithelioid cells with a vesicular nuclear chromatin pattern, prominent nucleoli and weakly eosinophic or basophilic cytoplasm embedded in the abundant myxoid stroma with lymphocytes infiltration. They were positive for ALK, Desmin, SMA, CD30, but negative for AE1/AE3, LCA, CD2, CD3, CD5, CD7, S-100, CD34, CD31, EMA, MyoD1, and myogenin. An elevated proliferation index was demonstrated by Ki-67 comparing the first and the second lesion. Fluorescence in situ (FISH) showed the presence of chromosomal translocation involving ALK. This case show EIMS is a rare variant of inflammatory myofibroblatic tumor with aggressive biological behavior and unfavourable prognosis. To be familiar with its significant clinicopathologic characteristics could prompt us to take it into consideration when facing the relevant dieases.

Keywords: ALK; Epithelioid inflammatory myofibroblastic scarcoma; FISH; soft tissue neoplasm.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdominal Neoplasms / chemistry
  • Abdominal Neoplasms / genetics
  • Abdominal Neoplasms / pathology
  • Abdominal Neoplasms / surgery*
  • Anaplastic Lymphoma Kinase
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / genetics
  • Biopsy
  • Cell Proliferation
  • Child
  • Diagnosis, Differential
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization, Fluorescence
  • Inflammation* / genetics
  • Inflammation* / pathology
  • Male
  • Myofibroblasts* / chemistry
  • Myofibroblasts* / pathology
  • Neoplasm Recurrence, Local*
  • Predictive Value of Tests
  • Receptor Protein-Tyrosine Kinases / genetics
  • Sarcoma / chemistry
  • Sarcoma / genetics
  • Sarcoma / pathology
  • Sarcoma / surgery*
  • Soft Tissue Neoplasms / chemistry
  • Soft Tissue Neoplasms / genetics
  • Soft Tissue Neoplasms / pathology
  • Soft Tissue Neoplasms / surgery*
  • Translocation, Genetic
  • Treatment Outcome
  • Tumor Burden

Substances

  • Biomarkers, Tumor
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases