Comprehensive Tissue Genomic Profiling Reveals ALK-EML4 Fusionand TP53 Splice-Site Mutation in Metastatic Lung Adenocarcinoma

74y female diagnosed with metastatic endometrioid carcinoma.
• Findings: Total hysterectomy with BSO & B/L pelvic lymph nodes dissection. Histopathology revealed endometrioid 
carcinoma of uterine corpus, FIGO GII; 3 left pelvic lymph nodes show metastatic carcinoma, FIGO stage IB, 
pT1bpN1a. IHC shows endometrial tumor cells positive ER.PR.PAX and p16 patchy positivity, WT1, NapsinA, GATA 3 
TTF1, Calretinin, CD10 were negative. SATB2 positive in squamous morules, Wild type p53, MMR protein deficient 
(loss of expression of MLH1 & PMS2- MSI-H). Histopathology of right ovary Benign cystic Brenner tumor epithelial 
cells positive for CK7,GATA 3and EMA. 
• Further evaluation: Genomic profiling via OncoIndx 360 Tbx to identify actionable alterations and guide 
personalized therapy. 
Clinical Challenges
How should adjuvant treatment be tailored in node-positive disease with MMR deficiency