case_images: PMC10585149_01
case_images: Comparison of images before and after ensartinib treatment. (A) Before surgery; (B) After surgery; (C) Postoperative review in November; (D) anlotinib post-treatment; (E) After 2 months on Ensartinib; (F) After 8 months on Ensartinib.
case_images: fonc-13-1252221-g001.jpg
case_images: PMC10585149_03_fonc-13-1252221-g001.jpg
case_images: f1
case_images: After two months of ensartinib treatment, a notable reduction in the subseptal soft tissue nodules was observed ( Figure 1E ). Eight months later, CT scans showed a significant reduction in the number of subdiaphragmatic soft tissue nodules, and the efficacy was evaluated as a partial response (PR) according to the first edition of the Criteria for the Evaluation of the Efficacy of Solid Tumours ( Figure 1F ).
case_images: Hematoxylin-eosin staining and immunohistochemistry findings: (A) The lesion is infiltrated by epithelioid cells and numerous mature inflammatory cells (magnification, x200); (B) Tumor tissue junction with normal tissue (magnification, x200); (C) ALK positivity (magnification, x200); (D) CD117 weakly positive (magnification, x200); (E) Vimentin positivity (magnification, x200).
case_images: fonc-13-1252221-g002.jpg
case_images: PMC10585149_01_fonc-13-1252221-g002.jpg
case_images: f2
case_images: The morphological diagnosis in this case was primarily based on the following criteria: 1) microscopic tumor cells displaying an epithelioid morphology with prominent nucleoli and easily discernible nuclear divisions were observed ( Figures 2A, B ); 2) interstitial infiltration with a large number of mature inflammatory cells, including neutrophils, lymphocytes, and eosinophils, and mucous degeneration were observed in the interstitium ( Figures 2A, B ); and 3) robust positivity for ALK ( Figure 2C ) was detected in plasma samples. In this case, ALK positivity was specific to this tumor; the presence of CD117 (scattered +) ( Figure 2D ) and absence of Dog1 (-) ruled out mesenchymal tumors, the absence of HMB45 (-) ruled out malignant melanoma, and diffuse positivity for vimentin ( Figure 2E ) was consistent with EIMS.
case_images: PMC10585149_02
case_images: Comparison of images before and after ensartinib treatment. (A) Before surgery; (B) After surgery; (C) Postoperative review in November; (D) anlotinib post-treatment; (E) After 2 months on Ensartinib; (F) After 8 months on Ensartinib.
case_images: fonc-13-1252221-g001.jpg
case_images: PMC10585149_03_fonc-13-1252221-g001.jpg
case_images: f1
case_images: After two months of ensartinib treatment, a notable reduction in the subseptal soft tissue nodules was observed ( Figure 1E ). Eight months later, CT scans showed a significant reduction in the number of subdiaphragmatic soft tissue nodules, and the efficacy was evaluated as a partial response (PR) according to the first edition of the Criteria for the Evaluation of the Efficacy of Solid Tumours ( Figure 1F ).
case_images: PMC10585149_03
case_images: Comparison of images before and after ensartinib treatment. (A) Before surgery; (B) After surgery; (C) Postoperative review in November; (D) anlotinib post-treatment; (E) After 2 months on Ensartinib; (F) After 8 months on Ensartinib.
case_images: fonc-13-1252221-g001.jpg
case_images: PMC10585149_03_fonc-13-1252221-g001.jpg
case_images: f1
case_images: After two months of ensartinib treatment, a notable reduction in the subseptal soft tissue nodules was observed ( Figure 1E ). Eight months later, CT scans showed a significant reduction in the number of subdiaphragmatic soft tissue nodules, and the efficacy was evaluated as a partial response (PR) according to the first edition of the Criteria for the Evaluation of the Efficacy of Solid Tumours ( Figure 1F ).
case_images: The schematic structure of the STRN-ALK fusion points.
case_images: fonc-13-1252221-g003.jpg
case_images: PMC10585149_03_fonc-13-1252221-g003.jpg
case_images: f3
case_images: The STRN-ALK transcript was found to be located in exon 3 of STRN and in exon 20 of ALK ( Figure 3 ).