Unusual synchronous double primary treatment-naïve lung adenocarcinoma harboring T790M and L858R mutations in early-stage lung cancer
| Autor: | Po-Ju Chen, Ching-Fu Weng, Ailun Heather Tseng, Shih-Hung Huang, Henry Hsin-Chung Lee |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
SMPNSCLC Pathology medicine.medical_specialty Lung Neoplasms lcsh:Surgery Adenocarcinoma of Lung Case Report lcsh:RC254-282 Lesion Neoplasms Multiple Primary 03 medical and health sciences T790M 0302 clinical medicine Surgical oncology Carcinoma Non-Small-Cell Lung Biopsy medicine Humans Epidermal growth factor receptor Lung cancer Aged Neoplasm Staging Lung medicine.diagnostic_test biology Synchronous multiple primary non-small cell lung cancer business.industry lcsh:RD1-811 medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens respiratory tract diseases ErbB Receptors medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Mutation biology.protein Adenocarcinoma 030211 gastroenterology & hepatology Surgery medicine.symptom business |
| Zdroj: | World Journal of Surgical Oncology, Vol 17, Iss 1, Pp 1-6 (2019) World Journal of Surgical Oncology |
| ISSN: | 1477-7819 |
| DOI: | 10.1186/s12957-019-1688-3 |
| Popis: | Background Concurrent mutations of synchronous multiple primary non-small cell lung cancer (SMPNSCLC) is rare, and only a few cases have been reported. Herein, we present a case of early-stage SMPNSCLC with T790M and L858R mutations. Case presentation A 68-year-old male patient presented to the Thoracic Surgery Department due to a tumor in the right lower lung. The tumor was detected more than 5 years previously during a health examination; however, the patient ignored the problem because the clinician at that time stated that the lesion was highly likely to be benign. Chest computed topography (CT) was ordered and the images showed a well-defined tumor in the right lower lung and a faint nodular lesion over the left lower lung field. A CT-guided biopsy results showed the presence of atypical cells and positive staining of TTF-1 and CK7. Surgical intervention was performed. The right- and left-sided tumors disclosed micropapillary predominant adenocarcinoma and acinar-predominant adenocarcinoma, respectively. Both tumors were positive for TTF-1 but negative for ALK and p40. Real-time PCR analysis showed that the right-sided tumor had an epidermal growth factor receptor (EGFR) mutation presenting as point mutation T790M in exon 20, while the left-sided tumor had a point mutation L858R in exon 21 of EGFR. Conclusions Our patient’s case suggests that tumors resembling a benign pattern with central calcification may be misdiagnosed. Thus, early screening for lung cancer is important, and intensive efforts to make a diagnosis through surgical resection or biopsies to allow for tailored optimal treatment may be preferential for the best patient outcomes. |
| Databáze: | OpenAIRE |
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