Presence of anaplastic lymphoma kinase translocation in sarcomatoid carcinoma of head and neck and treatment effect of crizotinib: A case series

Background Sarcomatoid carcinoma of the upper aerodigestive tract, a variant of squamous cell carcinoma, is a rare biphasic tumor consisting of epithelial and mesenchymal components. Methods and Results We report a case of 34-year-old woman with a relapsed refractory sarcomatoid carcinoma in the maxillary sinus. Because anaplastic lymphoma kinase (ALK) translocation is common in sarcoma, ALK fluorescence in situ hybridization (FISH) was performed and the result was positive. After crizotinib was administered, clinical improvement and stable disease lasted for 4 months. To identify the incidence of ALK rearrangement in this disease entity, ALK FISH was performed on tumor samples of 10 patients. Among them, 2 patients were positive. Conclusion To the best of our knowledge, this is the first case report demonstrating the clinical benefit of crizotinib in sarcomatoid carcinoma of the head and neck with ALK translocation. Our results suggest that the ALK FISH test may be suitable and encouraged for patients with sarcomatoid carcinoma of the head and neck.