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Case Reports
. 2025 May 2:15:1481602.
doi: 10.3389/fonc.2025.1481602. eCollection 2025.

Case Report: Clinical response of ensartinib for inflammatory myofibroblastic tumor of the urinary bladder with multiple metastases and TPM4-ALK fusion

Hongtao Ren  1 , Qi Cheng  2 , Xi Chen  3 , Dianjing Sui  1 , Zhiyi Zhang  1 , Fei Chen  1
Affiliations
Case Reports

Case Report: Clinical response of ensartinib for inflammatory myofibroblastic tumor of the urinary bladder with multiple metastases and TPM4-ALK fusion

Hongtao Ren et al. Front Oncol. .

Abstract

Background: Inflammatory myofibroblastic tumor of the urinary bladder (IMTUB) is a rare tumor with low postoperative recurrence and metastasis. Due to the lack of clinical evidence, the optimal treatment paradigm for patients with IMTUB has not yet been established.

Case presentation: We reported a case of a 55-year-old man who was diagnosed with bladder malignancy after transurethral resection of a bladder tumor, and then tumor metastasis was treated by traditional Chinese medicine. Following further disease progression, he was admitted to our hospital, where the diagnosis was revised to IMTUB with multiple metastases and TPM4-anaplastic lymphoma kinase (ALK) fusion by computed tomography (CT) scan, pathological diagnosis, immunohistochemistry, and genetic testing. The patient subsequently received 225 mg ensartinib once daily. Symptoms improved and achieved partial response (PR) with acceptable toxicities.

Conclusion: Ensartinib may provide a new therapeutic direction with promising efficacy and an acceptable safety profile for IMTUB with ALK fusion. Further clinical investigation is needed to identify its efficacy and safety.

Keywords: TPM4-ALK; ensartinib; inflammatory myofibroblastic tumor; multiple metastases; urinary bladder.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Target lesions of the patient with IMTUB by CT scans. (A) CT scans indicated space-occupying lesions of the bladder, with peritoneal and pelvic metastasis. (B) CT scans revealed tumors had decreased in size, achieving partial response after receiving ensartinib treatment. (C) Recent follow-up CT scans showed that the patient maintained partial response. IMTUB, inflammatory myofibroblastic tumor of the urinary bladder; CT, computed tomography.
Figure 2
Figure 2
Morphologic features and IHC staining of the IMTUB samples. (A) Representative pictures of H&E staining (×100). (B) IHC analysis of ALK, Vimentin, WT-1, and Ki-67 expression levels (×100). H&E, hematoxylin and eosin; IHC, immunohistochemistry; IMTUB, inflammatory myofibroblastic tumor of the urinary bladder.
See this image and copyright information in PMC

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