Coexistence of an EGFR Mutation and an ALK Rearrangement in a Patient with Lung Adenocarcinoma: a Case Report.
- Author:
Min Ah KIM
1
;
Jin Hyoung KANG
;
In Ho KIM
;
Tae Jung KIM
;
Seung Joon KIM
;
Sook Whan SUNG
;
Sol Mi HUO
Author Information
- Publication Type:Case Report
- Keywords: EGFR; ALK; Adenocarcinoma
- MeSH: Adenocarcinoma*; Ambulatory Care Facilities; Brain; Chemotherapy, Adjuvant; Drug Therapy; Exons; Female; Humans; Lung*; Lymph Node Excision; Lymphoma; Magnetic Resonance Imaging; Phosphotransferases; Point Mutation; Receptor, Epidermal Growth Factor; Recurrence; Tinnitus
- From:Korean Journal of Medicine 2016;90(1):72-77
- CountryRepublic of Korea
- Language:English
- Abstract: A 58 year-old woman was diagnosed with lung adenocarcinoma (cT3N1M0). We detected a point mutation in epidermal growth factor receptor (EGFR) exon 21 (L858R) and an echinoderm microtubule-associated protein-like 4- anaplastic lymphoma kinase (ALK) rearrangement. The patient was treated with preoperative neoadjuvant chemotherapy and underwent a left lower lobectomy with mediastinal lymph node dissection. However, we could not detect any mutation in EGFR or the ALK rearrangement from the tumor tissue removed. Then, 70 days after completion of adjuvant chemotherapy, she visited our outpatient clinic with diminished visual accuracy and tinnitus. A single brain metastatic lesion was seen on brain magnetic resonance imaging. She underwent surgical removal of the brain mass, which showed a mutation of EGFR, exon 21, but no ALK rearrangement. We report this unusual case of lung adenocarcinoma with a coexisting EGFR mutation and ALK rearrangement, and identify gene alterations before chemotherapy, after chemotherapy, and at recurrence.
