{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:06:18Z","timestamp":1790125578073,"version":"4.0.1"},"reference-count":17,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal neoplasm with intermediate biologic potential that rarely involves the female genital tract. Distinguishing IMT from other pelvic spindle cell tumors can be challenging, particularly in patients with a prior history of uterine smooth muscle neoplasms. We report a 59\u2010year\u2010old woman who underwent hysterectomy for a smooth muscle tumor of uncertain malignant potential and presented 8\u2009years later with recurrent small bowel obstruction and right flank pain. Imaging revealed a large infiltrative pelvic mass involving ovaries, ureter, small bowel, peritoneum, and iliac vessels. She underwent extensive multidisciplinary surgery, including small bowel resection, right nephrectomy, and vascular reconstruction. Histopathologic examination demonstrated a fascicular proliferation of spindle cells associated with a prominent lymphoplasmacytic inflammatory infiltrate. Diffuse anaplastic lymphoma kinase (ALK) expression was identified by immunohistochemistry, and fluorescence in\u00a0situ hybridization demonstrated an\n                    <jats:italic>ALK<\/jats:italic>\n                    rearrangement, supporting the diagnosis of ALK\u2010positive IMT. Identification of the\n                    <jats:italic>ALK<\/jats:italic>\n                    rearrangement directly influenced treatment selection and enabled initiation of ALK\u2010targeted therapy. This case highlights the diagnostic challenges posed by pelvic spindle cell neoplasms in a patient with a history of uterine smooth muscle neoplasms and underscores the importance of integrating morphologic, immunohistochemical, and molecular findings to establish an accurate diagnosis and guide targeted therapy.\n                  <\/jats:p>","DOI":"10.1111\/jog.70495","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:32:36Z","timestamp":1788841956000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pelvic\n                    <scp>ALK<\/scp>\n                    \u2010Positive Inflammatory Myofibroblastic Tumor Presenting 8\u2009Years After Uterine Smooth Muscle Tumor of Uncertain Malignant Potential"],"prefix":"10.1111","volume":"52","author":[{"given":"Aleah R.","family":"Singleton","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology LSU LCMC Health Cancer Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang R.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Hematology and Oncology LSU LCMC Health Cancer Center  New Orleans Louisiana USA"},{"name":"Department of Genetics LSU LCMC Health Cancer Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle M.","family":"De Jesus Ortiz","sequence":"additional","affiliation":[{"name":"Department of Pathology LSU LCMC Health Cancer Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monika A.","family":"Rak","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Oncology LSU LCMC Health Cancer Center  New Orleans Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carley","family":"Knudsen","sequence":"additional","affiliation":[{"name":"Department of 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