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{{DISPLAYTITLE:Inflammatory myofibroblastic tumour}} | |||
[[BRST5:Table_of_Contents|Breast Tumours (WHO Classification, 5th ed.)]] | |||
{{Under Construction}} | |||
<span style="color:#0070C0">(''General Instructions – The focus of these pages is the clinically significant genetic alterations in each disease type. This is based on up-to-date knowledge from multiple resources such as PubMed and the WHO classification books. The CCGA is meant to be a supplemental resource to the WHO classification books; the CCGA captures in a continually updated wiki-stye manner the current genetics/genomics knowledge of each disease, which evolves more rapidly than books can be revised and published. If the same disease is described in multiple WHO classification books, the genetics-related information for that disease will be consolidated into a single main page that has this template (other pages would only contain a link to this main page). Use [https://www.genenames.org/ <u>HUGO-approved gene names and symbols</u>] (italicized when appropriate), [https://varnomen.hgvs.org/ <u>HGVS-based nomenclature for variants</u>], as well as generic names of drugs and testing platforms or assays if applicable. Please complete tables whenever possible and do not delete them (add N/A if not applicable in the table and delete the examples); to add (or move) a row or column in a table, click nearby within the table and select the > symbol that appears. Please do not delete or alter the section headings. The use of bullet points alongside short blocks of text rather than only large paragraphs is encouraged. Additional instructions below in italicized blue text should not be included in the final page content. Please also see'' </span><u>''[[Author_Instructions]]''</u><span style="color:#0070C0"> ''and [[Frequently Asked Questions (FAQs)|<u>FAQs</u>]] as well as contact your [[Leadership|<u>Associate Editor</u>]] or [mailto:CCGA@cancergenomics.org <u>Technical Support</u>].)''</span> | |||
==Primary Author(s)*== | |||
Katherine Geiersbach, MD, Mayo Clinic - Rochester, MN, USA | |||
==WHO Classification of Disease== | |||
= | {| class="wikitable" | ||
!Structure | |||
!Disease | |||
|- | |||
|Book | |||
|Breast Tumours (5th ed.) | |||
|- | |||
|Category | |||
|Mesenchymal tumours of the breast | |||
|- | |||
|Family | |||
|Fibroblastic and myofibroblastic tumours | |||
|- | |||
|Type | |||
|Inflammatory myofibroblastic tumour | |||
|- | |||
|Subtype(s) | |||
|N/A | |||
|} | |||
== | ==Related Terminology== | ||
{| class="wikitable" | {| class="wikitable" | ||
| | |+ | ||
| | |Acceptable | ||
|N/A | |||
|- | |- | ||
| | |Not Recommended | ||
| | |Inflammatory pseudotumour | ||
|} | |} | ||
== | ==Gene Rearrangements== | ||
Formerly referred to as inflammatory pseudotumor, inflammatory myofibroblastic tumor of the breast relies upon morphologic, immunohistochemical, and/or molecular features shared in common with other primary tumor sites.<ref>{{Cite journal|last=Khanafshar|first=Elham|last2=Phillipson|first2=Julia|last3=Schammel|first3=David P.|last4=Minobe|first4=Lorraine|last5=Cymerman|first5=Judith|last6=Weidner|first6=Noel|date=2005-06|title=Inflammatory myofibroblastic tumor of the breast|url=https://pubmed.ncbi.nlm.nih.gov/15944952|journal=Annals of Diagnostic Pathology|volume=9|issue=3|pages=123–129|doi=10.1016/j.anndiagpath.2005.02.001|issn=1092-9134|pmid=15944952}}</ref><ref>{{Cite journal|last=Haj|first=Mahmoud|last2=Weiss|first2=Michael|last3=Loberant|first3=Norman|last4=Cohen|first4=Isaac|date=2003|title=Inflammatory pseudotumor of the breast: case report and literature review|url=https://pubmed.ncbi.nlm.nih.gov/12968967|journal=The Breast Journal|volume=9|issue=5|pages=423–425|doi=10.1046/j.1524-4741.2003.09516.x|issn=1075-122X|pmid=12968967}}</ref><ref>{{Cite journal|last=Zhao|first=Hua-Dong|last2=Wu|first2=Tao|last3=Wang|first3=Jun-Qing|last4=Zhang|first4=Wen-Dong|last5=He|first5=Xian-Li|last6=Bao|first6=Guo-Qiang|last7=Li|first7=Yi|last8=Gong|first8=Li|last9=Wang|first9=Qing|date=2013-01|title=Primary inflammatory myofibroblastic tumor of the breast with rapid recurrence and metastasis: A case report|url=https://pubmed.ncbi.nlm.nih.gov/23255901|journal=Oncology Letters|volume=5|issue=1|pages=97–100|doi=10.3892/ol.2012.948|issn=1792-1074|pmc=3525499|pmid=23255901}}</ref><ref>{{Cite journal|last=Kovács|first=Anikó|last2=Máthé|first2=Gyöngyvér|last3=Mattsson|first3=Jan|last4=Stenman|first4=Göran|last5=Kindblom|first5=Lars-Gunnar|date=2015|title=ALK-Positive Inflammatory Myofibroblastic Tumor of the Nipple During Pregnancy-An Unusual Presentation of a Rare Disease|url=https://pubmed.ncbi.nlm.nih.gov/25772857|journal=The Breast Journal|volume=21|issue=3|pages=297–302|doi=10.1111/tbj.12404|issn=1524-4741|pmid=25772857}}</ref> Confirmation of rearrangements of ''ALK'' or, less commonly other receptor tyrosine kinase genes, supports the diagnosis and can identify therapeutic targets<ref>{{Cite journal|last=Chmiel|first=Paulina|last2=SłOWIKOWSKA|first2=Aleksandra|last3=Banaszek|first3=Łukasz|last4=Szumera-CIEćKIEWICZ|first4=Anna|last5=Szostakowski|first5=BARTłOMIEJ|last6=SPAłEK|first6=Mateusz J.|last7=Świtaj|first7=Tomasz|last8=Rutkowski|first8=Piotr|last9=Czarnecka|first9=Anna M.|date=2024|title=Inflammatory myofibroblastic tumor from molecular diagnostics to current treatment|url=https://pubmed.ncbi.nlm.nih.gov/38948020|journal=Oncology Research|volume=32|issue=7|pages=1141–1162|doi=10.32604/or.2024.050350|issn=1555-3906|pmc=PMC11209743|pmid=38948020}}</ref>. However, molecular confirmation is not required if ALK immunohistochemistry is definitively positive.<ref>{{Cite journal|last=Coffin|first=C. M.|last2=Patel|first2=A.|last3=Perkins|first3=S.|last4=Elenitoba-Johnson|first4=K. S.|last5=Perlman|first5=E.|last6=Griffin|first6=C. A.|date=2001-06|title=ALK1 and p80 expression and chromosomal rearrangements involving 2p23 in inflammatory myofibroblastic tumor|url=https://pubmed.ncbi.nlm.nih.gov/11406658|journal=Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc|volume=14|issue=6|pages=569–576|doi=10.1038/modpathol.3880352|issn=0893-3952|pmid=11406658}}</ref><ref>{{Cite journal|last=Cook|first=J. R.|last2=Dehner|first2=L. P.|last3=Collins|first3=M. H.|last4=Ma|first4=Z.|last5=Morris|first5=S. W.|last6=Coffin|first6=C. M.|last7=Hill|first7=D. A.|date=2001-11|title=Anaplastic lymphoma kinase (ALK) expression in the inflammatory myofibroblastic tumor: a comparative immunohistochemical study|url=https://pubmed.ncbi.nlm.nih.gov/11684952|journal=The American Journal of Surgical Pathology|volume=25|issue=11|pages=1364–1371|doi=10.1097/00000478-200111000-00003|issn=0147-5185|pmid=11684952}}</ref><ref>{{Cite journal|last=Pickett|first=Justine L.|last2=Chou|first2=Angela|last3=Andrici|first3=Juliana A.|last4=Clarkson|first4=Adele|last5=Sioson|first5=Loretta|last6=Sheen|first6=Amy|last7=Reagh|first7=Jessica|last8=Najdawi|first8=Fedaa|last9=Kim|first9=Yoomee|date=2017-10|title=Inflammatory Myofibroblastic Tumors of the Female Genital Tract Are Under-recognized: A Low Threshold for ALK Immunohistochemistry Is Required|url=https://pubmed.ncbi.nlm.nih.gov/28731868|journal=The American Journal of Surgical Pathology|volume=41|issue=10|pages=1433–1442|doi=10.1097/PAS.0000000000000909|issn=1532-0979|pmc=5598906|pmid=28731868}}</ref> Of note, exceptional situations such as inversions or other cryptic rearrangements of ''ALK'' at 2p23 may lead to a false-negative FISH result<ref>{{Cite journal|last=Haimes|first=Josh D.|last2=Stewart|first2=Colin J. R.|last3=Kudlow|first3=Brian A.|last4=Culver|first4=Brady P.|last5=Meng|first5=Bo|last6=Koay|first6=Eleanor|last7=Whitehouse|first7=Ann|last8=Cope|first8=Nichola|last9=Lee|first9=Jen-Chieh|date=2017-06|title=Uterine Inflammatory Myofibroblastic Tumors Frequently Harbor ALK Fusions With IGFBP5 and THBS1|url=https://pubmed.ncbi.nlm.nih.gov/28490045|journal=The American Journal of Surgical Pathology|volume=41|issue=6|pages=773–780|doi=10.1097/PAS.0000000000000801|issn=1532-0979|pmid=28490045}}</ref>, and other molecular testing such as RNA-Seq can be used to detect ''ALK'' fusions efficiently. In ALK-negative cases, immunohistochemistry for ROS1 and/or molecular tests for non-''ALK'' gene fusions may be useful.<ref name=":0">{{Cite journal|last=Lovly|first=Christine M.|last2=Gupta|first2=Abha|last3=Lipson|first3=Doron|last4=Otto|first4=Geoff|last5=Brennan|first5=Tina|last6=Chung|first6=Catherine T.|last7=Borinstein|first7=Scott C.|last8=Ross|first8=Jeffrey S.|last9=Stephens|first9=Philip J.|date=2014-08|title=Inflammatory myofibroblastic tumors harbor multiple potentially actionable kinase fusions|url=https://pubmed.ncbi.nlm.nih.gov/24875859|journal=Cancer Discovery|volume=4|issue=8|pages=889–895|doi=10.1158/2159-8290.CD-14-0377|issn=2159-8290|pmc=4125481|pmid=24875859}}</ref><ref>{{Cite journal|last=Hornick|first=Jason L.|last2=Sholl|first2=Lynette M.|last3=Dal Cin|first3=Paola|last4=Childress|first4=Merrida A.|last5=Lovly|first5=Christine M.|date=2015-05|title=Expression of ROS1 predicts ROS1 gene rearrangement in inflammatory myofibroblastic tumors|url=https://pubmed.ncbi.nlm.nih.gov/25612511|journal=Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc|volume=28|issue=5|pages=732–739|doi=10.1038/modpathol.2014.165|issn=1530-0285|pmc=5874150|pmid=25612511}}</ref><ref name=":1">{{Cite journal|last=Yamamoto|first=Hidetaka|last2=Yoshida|first2=Akihiko|last3=Taguchi|first3=Kenichi|last4=Kohashi|first4=Kenichi|last5=Hatanaka|first5=Yui|last6=Yamashita|first6=Atsushi|last7=Mori|first7=Daisuke|last8=Oda|first8=Yoshinao|date=2016-07|title=ALK, ROS1 and NTRK3 gene rearrangements in inflammatory myofibroblastic tumours|url=https://pubmed.ncbi.nlm.nih.gov/26647767|journal=Histopathology|volume=69|issue=1|pages=72–83|doi=10.1111/his.12910|issn=1365-2559|pmid=26647767}}</ref><ref>{{Cite journal|last=Lovly|first=Christine M.|last2=Gupta|first2=Abha|last3=Lipson|first3=Doron|last4=Otto|first4=Geoff|last5=Brennan|first5=Tina|last6=Chung|first6=Catherine T.|last7=Borinstein|first7=Scott C.|last8=Ross|first8=Jeffrey S.|last9=Stephens|first9=Philip J.|date=2014-08|title=Inflammatory myofibroblastic tumors harbor multiple potentially actionable kinase fusions|url=https://pubmed.ncbi.nlm.nih.gov/24875859|journal=Cancer Discovery|volume=4|issue=8|pages=889–895|doi=10.1158/2159-8290.CD-14-0377|issn=2159-8290|pmc=4125481|pmid=24875859}}</ref><ref name=":2">{{Cite journal|last=Alassiri|first=Ali H.|last2=Ali|first2=Rola H.|last3=Shen|first3=Yaoqing|last4=Lum|first4=Amy|last5=Strahlendorf|first5=Caron|last6=Deyell|first6=Rebecca|last7=Rassekh|first7=Rod|last8=Sorensen|first8=Poul H.|last9=Laskin|first9=Janessa|date=2016-08|title=ETV6-NTRK3 Is Expressed in a Subset of ALK-Negative Inflammatory Myofibroblastic Tumors|url=https://pubmed.ncbi.nlm.nih.gov/27259007|journal=The American Journal of Surgical Pathology|volume=40|issue=8|pages=1051–1061|doi=10.1097/PAS.0000000000000677|issn=1532-0979|pmid=27259007}}</ref><ref>{{Cite journal|last=Antonescu|first=Cristina R.|last2=Suurmeijer|first2=Albert J. H.|last3=Zhang|first3=Lei|last4=Sung|first4=Yun-Shao|last5=Jungbluth|first5=Achim A.|last6=Travis|first6=William D.|last7=Al-Ahmadie|first7=Hikmat|last8=Fletcher|first8=Christopher D. M.|last9=Alaggio|first9=Rita|date=2015-07|title=Molecular characterization of inflammatory myofibroblastic tumors with frequent ALK and ROS1 gene fusions and rare novel RET rearrangement|url=https://pubmed.ncbi.nlm.nih.gov/25723109|journal=The American Journal of Surgical Pathology|volume=39|issue=7|pages=957–967|doi=10.1097/PAS.0000000000000404|issn=1532-0979|pmc=4465992|pmid=25723109}}</ref> | |||
== | |||
== | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
! | !Driver Gene!!Fusion(s) and Common Partner Genes!!Molecular Pathogenesis!!Typical Chromosomal Alteration(s) | ||
!Prevalence -Common >20%, Recurrent 5-20% or Rare <5% (Disease) | |||
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T | |||
!Established Clinical Significance Per Guidelines - Yes or No (Source) | |||
!Clinical Relevance Details/Other Notes | |||
|- | |||
|''ALK''||''TPM3''::''ALK, TPM4''::''ALK, EML4''::''ALK'', ''RANBP2''::''ALK, CLTC''::''ALK'', and others||Fusions result in constitutive activation of the ''ALK'' tyrosine kinase. The most common ''ALK'' fusion breakpoints occur in intron 19 of ''ALK''. At the transcript level, a variable (5’) partner gene is fused to 3’ ''ALK'' at exon 20. At the DNA level, alternative ''ALK'' breakpoints in rare cases occur upstream of exon 19, most commonly in intron 18.||Rearrangements of ''ALK'' gene locus at 2p23 | |||
|Common | |||
|D, T | |||
|Yes (WHO) | |||
| | |||
|- | |- | ||
| | |''ROS1'' | ||
|''TFG''::''ROS1'', ''YWHAE''::''ROS1'', and others | |||
|Fusions result in constitutive activation of the ''ROS1'' tyrosine kinase. Most common ''ROS1'' breakpoints occur in intron 35; at the transcript level, various 5' partner genes are fused to exon 36 of ''ROS1''.<ref name=":0" /> | |||
|Rearrangements of ''ROS1'' gene locus at 6q22 | |||
|Recurrent | |||
|D, T | |||
|Yes (WHO) | |||
| | |||
|- | |- | ||
| | |''NTRK3'' | ||
|''ETV6''::''NTRK3'' and others | |||
|Fusions result in constitutive activation of the ''NTRK3'' tyrosine kinase. Most commonly exon 5 of ''ETV6'' is joined to exon 15 of ''NTRK3'' at the transcript level.<ref name=":1" /><ref name=":2" /> | |||
|Rearrangements of ''NTRK3'' gene locus at 15q25. Classically, the reciprocal translocation t(12;15)(p13;q25) is associated with ''ETV6''::''NTRK3'' rearrangement. | |||
|Recurrent | |||
|D, T | |||
|Yes (WHO) | |||
| | |||
|- | |- | ||
| | |''PDGFRB'' | ||
|''NAB2''::''PDGFRB''<ref name=":0" /> and others | |||
|Fusions result in constitutive activation of the ''PDGFRB'' tyrosine kinase.<ref name=":0" /> | |||
|Rearrangements of the ''PDGFRB'' gene locus at 5q32. | |||
|Rare | |||
|D, T | |||
|Yes (WHO) | |||
| | |||
|- | |- | ||
| | |''RET'' | ||
| | | | ||
|Fusions result in constitutive activation of the ''RET'' tyrosine kinase. | |||
|Rearrangements of the ''RET'' gene locus at 10q11. | |||
|Rare | |||
|D, T | |||
|Yes (WHO) | |||
| | |||
|- | |- | ||
|''NTRK1'' | |||
| | |||
|Fusions result in constitutive activation of the ''NTRK1'' tyrosine kinase. | |||
|Rearrangements of the ''NTRK1'' gene locus at 1q23. | |||
|Rare | |||
|D, T | |||
| | |||
| | |||
|- | |- | ||
| | |''IGF1R'' | ||
| | |||
| | |Fusions result in constitutive activation of the ''IGF1R'' tyrosine kinase. | ||
| | |Rearrangements of the ''IGF1R'' gene locus at 15q26. | ||
| | |Rare | ||
| | |D, T | ||
| | |||
| | |||
|} | |||
==Individual Region Genomic Gain/Loss/LOH== | |||
<br /> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
!Chr #!!Gain | !Chr #!!Gain, Loss, Amp, LOH!!Minimal Region Cytoband and/or Genomic Coordinates [Genome Build; Size]!!Relevant Gene(s) | ||
!Diagnostic | !Diagnostic, Prognostic, and Therapeutic Significance - D, P, T | ||
!Established Clinical Significance Per Guidelines - Yes or No (Source) | |||
! | !Clinical Relevance Details/Other Notes | ||
!Notes | |||
|- | |- | ||
| | | | ||
| | |||
| | |||
| | | | ||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | | | ||
| | |||
| | |||
| | | | ||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
|} | |} | ||
==Characteristic Chromosomal or Other Global Mutational Patterns== | |||
<br /> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
!Chromosomal Pattern | !Chromosomal Pattern | ||
! | !Molecular Pathogenesis | ||
!Prognostic Significance | !Prevalence - | ||
! | Common >20%, Recurrent 5-20% or Rare <5% (Disease) | ||
!Notes | !Diagnostic, Prognostic, and Therapeutic Significance - D, P, T | ||
!Established Clinical Significance Per Guidelines - Yes or No (Source) | |||
!Clinical Relevance Details/Other Notes | |||
|- | |||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
|- | |- | ||
| | | | ||
| | |||
| | |||
| | | | ||
| | | | ||
| | | | ||
| | |||
|} | |} | ||
==Gene Mutations (SNV/INDEL)== | |||
<br /> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
!Gene | !Gene!!Genetic Alteration!!Tumor Suppressor Gene, Oncogene, Other!!Prevalence - | ||
! | Common >20%, Recurrent 5-20% or Rare <5% (Disease) | ||
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T | |||
! | !Established Clinical Significance Per Guidelines - Yes or No (Source) | ||
!Notes | !Clinical Relevance Details/Other Notes | ||
|- | |- | ||
| | |<br /> | ||
| | |||
| | |||
| | |||
| | |||
| | |||
| | |||
| | | | ||
| | | | ||
| | | | ||
|}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content. | |||
|} | |||
Note: A more extensive list of mutations can be found in | |||
==Epigenomic Alterations== | ==Epigenomic Alterations== | ||
<br /> | |||
==Genes and Main Pathways Involved== | ==Genes and Main Pathways Involved== | ||
<br /> | |||
{| class="wikitable sortable" | {| class="wikitable sortable" | ||
|- | |- | ||
!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | !Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome | ||
|- | |- | ||
| | |''ALK, ROS1, NTRK3, NTRK1, RET, PDGFRB, RET,'' and other tyrosine kinase genes; Activating gene fusions | ||
| | |JAK/STAT3, PI3K, RAS/RAF/MAPK signaling | ||
| | |Increased cell growth and proliferation | ||
|- | |- | ||
| | | | ||
| | | | ||
| | | | ||
|} | |} | ||
==Genetic Diagnostic Testing Methods== | |||
Next generation sequencing and RT-PCR for fusion detection; FISH; immunohistochemistry for ''ALK, ROS1'' (less sensitive/specific), and ''NTRK1/2/3'' fusion detection. | |||
==Familial Forms== | ==Familial Forms== | ||
None | |||
==Additional Information== | |||
<br /> | |||
==Links== | |||
== | Put a link here or anywhere appropriate in this page <span style="color:#0070C0">(''Instructions: Highlight the text to which you want to add a link in this section or elsewhere, select the "Link" icon at the top of the wiki page, and search the name of the internal page to which you want to link this text, or enter an external internet address by including the "<nowiki>http://www</nowiki>." portion.'')</span> | ||
==Notes== | |||
<nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page. If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the [[Leadership|''<u>Associate Editor</u>'']] or other CCGA representative. When pages have a major update, the new author will be acknowledged at the beginning of the page, and those who contributed previously will be acknowledged below as a prior author. | |||
Prior Author(s): | |||
Yajuan Liu, PhD<br /> | |||
==References== | ==References== | ||
<br /> | |||
<references /> | |||
<nowiki>*</nowiki>''Citation of this Page'': “Inflammatory myofibroblastic tumour”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/BRST5:Inflammatory myofibroblastic tumour</nowiki>. | |||
[[Category:BRST5]] | |||
[[Category:DISEASE]] | |||
[[Category:Diseases I]] | |||