Korean J Med.
2016 Jan;90(1):72-77. 10.3904/kjm.2016.90.1.72.
Coexistence of an EGFR Mutation and an ALK Rearrangement in a Patient with Lung Adenocarcinoma: a Case Report
- Affiliations
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- 1Division of Medical Oncology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. jinkang@catholic.ac.kr
- 2Department of Hospital Pathology, The Catholic University of Korea College of Medicine, Seoul, Korea.
- 3Division of Pulmonology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
- 4Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
- KMID: 2268896
- DOI: http://doi.org/10.3904/kjm.2016.90.1.72
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.
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