Imaging findings of NTRK‑rearranged spindle cell neoplasms: A case series

Kobayashi,Hiroshi; Teramura,Yasuyo; Yamashita,Kyoko; Makise,Naohiro; Ae,Keisuke; Tanaka,Sakae

doi:10.3892/mco.2023.2610

Imaging findings of NTRK‑rearranged spindle cell neoplasms: A case series

Authors:
- Hiroshi Kobayashi
- Yasuyo Teramura
- Kyoko Yamashita
- Naohiro Makise
- Keisuke Ae
- Sakae Tanaka
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Affiliations: Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo 113‑8655, Japan, Division of Carcinogenesis, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo 135‑8550, Japan, Department of Pathology, The Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo 135‑8550, Japan, Department of Pathology, The University of Tokyo, Tokyo 113‑8655, Japan, Department of Orthopedic Oncology, The Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo 135‑8550, Japan
Published online on: January 23, 2023 https://doi.org/10.3892/mco.2023.2610
Article Number: 14
Copyright: © Kobayashi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

NTRK‑rearranged spindle cell neoplasms (NTRK‑RSCNs) are a new category of soft tissue tumors with NTRK gene fusions. The present study aimed to investigate the radiological features of NTRK‑RSCNs and their association with histopathological findings. The present study included six patients with NTRK‑RSCNs, whose fusion genes were confirmed using next‑generation sequencing. All patients underwent surgery, and their diagnosis and clinical outcomes were investigated. In addition, the magnetic resonance imaging (MRI) features of all tumors and histopathological findings of the resected specimens were assessed. The present study included three women and three men, with a mean age of 22 years (range, 2‑43 years). The NTRK gene fusions included four NTRK1 and two NTRK3 fusions. Three patients were preoperatively diagnosed with solitary fibrous tumors. One patient with NTRK3 fusion experienced local recurrence and distant metastases, whereas the other five patients had no local recurrence or metastasis. MRI revealed that all tumors were highly vascular with intra‑ and peritumoral flow voids of differing degrees. Furthermore, a partially ill‑defined border, suggesting infiltration of tumors into the surrounding tissues, particularly fat tissue, was observed in five patients, which was confirmed by histopathological findings. In conclusion, NTRK‑RSCNs are highly vascular tumors that can infiltrate the surrounding tissues. These findings suggested that NTRK‑RSCNs should be considered in the differential diagnosis of highly vascular‑rich mesenchymal tumors, including solitary fibrous tumors and alveolar soft part sarcomas. Furthermore, wide resection may be preferred to completely resect this type of tumor, considering its invasive nature.

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