Furugen Makoto, Uechi Kayoko, Hirai Jun, Aoyama Hajime, Saio Masanao, Yoshimi Naoki, Kinjo Takeshi, Miyagi Kazuya, Haranaga Shusaku, Higa Futoshi, Tateyama Masao, Fujita Jiro
Department of Infectious, Respiratory, and Digestive Medicine, Control and Prevention of Infectious Diseases (The First Department of Internal Medicine), Faculty of Medicine, University of the Ryukyus, Japan.
Intern Med. 2015;54(19):2491-6. doi: 10.2169/internalmedicine.54.5481. Epub 2015 Oct 1.
We herein describe the case of a 63-year-old man who died from relapsed epidermal growth factor receptor gene (EGFR) exon 19 deletion lung adenocarcinoma treated with erlotinib. According to the autopsy results, he was confirmed to have small cell carcinoma without the EGFR T790M mutation in his pancreas and left kidney metastatic specimens, while the adenocarcinoma metastatic lesion in his right kidney had the EGFR T790M mutation; both retained the somatic EGFR exon 19 deletion. We herein report an autopsy case of resistance to an EGFR tyrosine kinase inhibitor via small cell carcinoma transformation and the EGFRT790M mutation in separate metastatic organs.
我们在此描述一例63岁男性病例，该患者死于复发的表皮生长因子受体基因（EGFR）外显子19缺失型肺腺癌，曾接受厄洛替尼治疗。根据尸检结果，在其胰腺和左肾转移标本中证实为无EGFR T790M突变的小细胞癌，而右肾的腺癌转移灶存在EGFR T790M突变；两者均保留了体细胞EGFR外显子19缺失。我们在此报告一例通过小细胞癌转化和不同转移器官中的EGFR T790M突变导致对EGFR酪氨酸激酶抑制剂耐药的尸检病例。
