title: Inflammatory myofibroblastic tumors of the central nervous system that express anaplastic lymphoma kinase have a high recurrence rate.
abstract: BACKGROUND
  Inflammatory myofibroblastic tumors (IMTs) of the central nervous system (CNS) are rare entities with diverse histopathological features and varying propensities to recur.
  
  
  METHODS
  A 26 year-old male with an IMT of the CNS of the left tentorium had tumor progression 2 months after partial surgical resection. Histopathological studies confirmed expression of ALK. Macroscopic total resection was performed followed by radiotherapy. A recurrence occurred 20 months after the second surgery that necessitate reoperation. Including the present case, we identified 30 cases of IMT of the CNS corresponding to our search criteria in the literature. The extent of resection was reported in 26 of these cases. Gross total resection was done in 75% of ALK-positive and in 61% of ALK-negative cases. Recurrence rate after gross total resection for ALK-positive and ALK-negative cases was 33% and 9%, respectively. Every recurrence in ALK-positive patients occurred within 2 years after surgery.
  
  
  CONCLUSIONS
  IMT of the CNS are a heterogeneous group of tumors and the treatment of choice is complete surgical resection. Because of the high recurrence rate reported for IMT of the CNS expressing ALK, a closed follow-up is recommended. When faced with an early recurrence, a surgical resection followed by radiotherapy may be advised.
authors.affiliation: Department of Surgery, Division of Neurosurgery, Centre Hospitalier de l'Université de Montréal, Hôpital Notre-Dame, Montreal, QC, Canada.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Denis
authors.forename: Karim
authors.initials: K
authors.lastname: Elayoubi
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Weil
authors.forename: France
authors.initials: F
authors.lastname: Berthelet
authors.forename: Michel W
authors.initials: MW
authors.lastname: Bojanowski
keywords: Anaplastic lymphoma kinase; fibrohistiocytic; inflammatory myofibroblastic tumor; plasma cell granuloma; pseudotumor; recurrence