Conjunctival TFG::ROS1 Fusion Positive Inflammatory Myofibroblastic Tumor Treated With Crizotinib

This case describes the clinical course and management of a conjunctival inflammatory myofibroblastic tumor with a transforming growth factor::ROS proto-oncogene 1 fusion in a 33-year-old woman presenting with a progressively enlarging subconjunctival mass. Diagnosis was confirmed by biopsy and RNA next-generation sequencing. Treatment with the tyrosine kinase inhibitor crizotinib led to complete tumor resolution; however, therapy was discontinued due to a sarcoid-like granulomatous reaction. Visual acuity remained stable at 20/20 throughout, and no recurrence was observed. This case highlights the diagnostic challenges of conjunctival inflammatory myofibroblastic tumor, the therapeutic potential of targeted kinase inhibition, and the critical role of genomic profiling in guiding personalized treatment for rare ocular tumors such as inflammatory myofibroblastic tumor.