ALK-Positive Inflammatory Myofibroblastic Tumor of the Nipple During Pregnancy-An Unusual Presentation of a Rare Disease

Breast J. 2015 May-Jun;21(3):297-302. doi: 10.1111/tbj.12404. Epub 2015 Mar 15.

Abstract

Inflammatory myofibroblastic tumors (IMT) is a benign to low-grade malignant neoplasm most commonly occurring in the viscera and soft tissues of children and young adults. Involvement of the breast is very rare. This report presents the first case of IMT of the nipple and highlights the histologic features and differential diagnosis at this unusual anatomical site. The patient was a 31-years-old pregnant woman with a palpable mass at the upper half of the left nipple. The lesion appeared after breastfeeding of her first child and increased in size during her second pregnancy. A conservative, incomplete surgical excision was performed in the 24th week of the second pregnancy. The residual tumor subsequently underwent spontaneous regression. There was no evidence of disease 5 years after surgery. FISH and immunohistochemical analyses revealed rearrangement and overexpression of the ALK gene, a typical feature of both pulmonary and extrapulmonary IMT.

Keywords: ALK overexpression; breast; gene fusion; inflammatory myofibroblastic tumor; nipple.

Publication types

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

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology*
  • Diagnosis, Differential
  • Female
  • Humans
  • Nipples / pathology*
  • Pregnancy
  • Pregnancy Complications, Neoplastic / diagnosis
  • Pregnancy Complications, Neoplastic / pathology
  • Rare Diseases
  • Receptor Protein-Tyrosine Kinases / genetics
  • Receptor Protein-Tyrosine Kinases / metabolism

Substances

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