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KMID : 0882420160900010072
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Korean Journal of Medicine
2016 Volume.90 No. 1 p.72 ~ p.77
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Coexistence of an EGFR Mutation and an ALK Rearrangement in a Patient with Lung Adenocarcinoma: a Case Report
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김민아:Kim Min-Ah
강진형:Kang Jin-Hyoung/김인호:Kim In-Ho/김태정:Kim Tae-Jung/김승준:Kim Seung-Joon/성숙환:Sung Sook-Whan/허솔미:Huo Sol-Mi
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Abstract
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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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KEYWORD
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EGFR, ALK, Adenocarcinoma
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