Wang Wenxian, Wu Wei, Zhang Yiping
Department of Chemotherapy Department of Pathology, Zhejiang Cancer Hospital Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2016 Jul;95(30):e4221. doi: 10.1097/MD.0000000000004221.
Lung cancer with ovarian metastasis or adnexal metastasis harboring anaplastic lymphoma kinase (ALK) gene translocation is rare. Crizotinib, a novel ALK tyrosine kinase inhibitor, has already shown an impressive single-agent activity in ALK positive lung cancer.
To summarize the case of clinical data and treatment of a 33-year-old woman with pelvic adnexal metastasis NSCLC.
Histological examination of the tumors showed lung adenocarcinoma. The right lung biopsy tissue and left adnexal mass biopsy tissue both revealed the presence of an ALK rearrangement by Ventana (D5F3) ALK immunohistochemistry assay (Ventana Medical Systems, Roche, Inc., Tuscon, AZ). The patient experienced a remarkable tumor response to crizotinib treatment.
Although the adnexal location is an uncommon metastasis site from lung cancer, oncologists should be aware of the possibility of such metastasis for female patients with ALK rearrangement NSCLC. Considering this remarkable response, we conclude that the presence of adnexal metastasis in NSCLC patients with ALK rearrangement should be attentive.
伴有间变性淋巴瘤激酶(ALK)基因易位的肺癌发生卵巢转移或附件转移较为罕见。克唑替尼是一种新型的ALK酪氨酸激酶抑制剂,已在ALK阳性肺癌中显示出令人瞩目的单药活性。
总结1例33岁伴有盆腔附件转移的非小细胞肺癌患者的临床资料及治疗情况。
肿瘤组织学检查显示为肺腺癌。右肺活检组织和左附件肿块活检组织通过Ventana(D5F3)ALK免疫组化检测(Ventana医疗系统公司,罗氏公司,亚利桑那州图森市)均显示存在ALK重排。该患者对克唑替尼治疗有显著的肿瘤反应。
尽管附件部位是肺癌不常见的转移部位,但肿瘤学家应意识到ALK重排的女性非小细胞肺癌患者发生此类转移的可能性。鉴于这种显著的反应,我们得出结论,对于ALK重排的非小细胞肺癌患者,应关注附件转移的存在。