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EML4::ALK fusions in complex lymphatic malformations
Authors:Beth Apsel Winger  Walter Patrick Devine  Edward C Hsiao  Matthew Zapala  Jessica Van Ziffle  Nalin Gupta  Ilona J Frieden  Kristin A Shimano
Institution:1. Department of Pediatrics, Division of Hematology, University of California San Francisco, San Francisco, California, USA;2. Department of Pathology, University of California San Francisco, San Francisco, California, USA;3. Department of Medicine, and the Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA;4. Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, California, USA;5. Department of Neurological Surgery, University of California San Francisco, San Francisco, California, USA;6. Department of Dermatology, University of California San Francisco, San Francisco, California, USA
Abstract:Gorham–Stout disease (GSD) and generalized lymphatic anomaly (GLA) are subtypes of complex lymphatic malformations (CLMs) with osseous involvement that cause significant complications, including pain and pathologic fractures. As with other vascular anomalies, somatic mosaic mutations in oncogenes are often present, and the mTOR inhibitor sirolimus alleviates symptoms in some, but not all, patients. We describe two patients, one with GSD and one with GLA, found to have EML4::ALK fusions. This report of a targetable, oncogenic fusion in vascular malformations expands our understanding of the genetic basis for CLMs and suggests additional targeted therapies could be effective.
Keywords:molecular genetics  pediatric hematology/oncology  signal transduction therapeutics  vascular malformations
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