Kongsak Loharamtaweethong1, Napaporn Puripat1, Nadda Aoonjai2, Apisada Sutepvarnon3,
Chanyoot Bandidwattanawong3
1Department of Anatomical Pathology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University,
Bangkok, Th ailand,
2Department of Medical Services, Electron Microscopy Laboratory, Institute of Pathology,
Ministry of Public Health, Bangkok, Th ailand, and
3Department of Medical Oncology, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University,
Bangkok, Thailand.
Objective: To report a case of paediatric malignant peritoneal mesothelioma (MPM) with evidence of
anaplastic lymphoma kinase (ALK) translocation.
Methods: We describe a 10-year-old girl who presented with abdominal pain and progressive abdominal
distension. She had no history of asbestos exposure. Histopathological, immunohistochemical and
ultrastructural analyses were performed and showed a biphasic malignant mesothelioma. In addition, we also
studied on a selected set of immunomarkers which may be the potential therapeutic molecular targets including
ALK, c-kit (CD117), epidermal growth factor receptor (EGFR) and human epidermal growth factor 2
(HER2)/neu, as well as corresponding molecular analysis.
Results: Tumour showed immunopositivity for ALK protein, together with evidence of ALK translocation
assessed by fl uorescent in-situ hybridization (FISH) analysis. HER2/neu showed weak immunopositivity
without evidence of HER2/neu amplifi cation, whereas no evidence of c-kit (CD117) and EGFR protein
expression were detected in tumour specimens.
Conclusions: Paediatric MPM is associated with ALK translocation in our case. The results may open up a
new avenue for the study of molecular genesis of paediatric malignant mesothelioma in the future and help to
determine whether patients MMs with ALK translocation would benefi t from ALK inhibitor treatment.