Moriya Rika, Hokari Satoshi, Shibata Satoshi, Koizumi Takeshi, Tetsuka Takafumi, Ito Kazuhiko, Hashidate Hideki, Tsukada Hiroki
Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Japan.
Department of Respiratory Medicine, Niigata City General Hospital, Japan.
Intern Med. 2017;56(15):2013-2017. doi: 10.2169/internalmedicine.56.7452. Epub 2017 Aug 1.
We herein report a 58-year-old Japanese woman who survived 14 years after surgery for lung adenocarcinoma harboring an epidermal growth factor receptor (EGFR) exon 19 deletion. She developed recurrence, for which she underwent multimodal therapy, including EGFR-tyrosine kinase inhibitor (TKI) administration. She ultimately died from a rapidly progressive right lung tumor that was resistant to EGFR-TKI. According to the autopsy findings, she had combined large-cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma in the right lung, which retained an EGFR exon 19 deletion in both components. Therefore, the histological transformation to LCNEC can be a mechanism of acquired EGFR-TKI resistance.
我们在此报告一名58岁的日本女性，她在接受携带表皮生长因子受体（EGFR）外显子19缺失的肺腺癌手术后存活了14年。她出现了复发，并接受了包括EGFR酪氨酸激酶抑制剂（TKI）给药在内的多模式治疗。她最终死于对EGFR-TKI耐药的快速进展性右肺肿瘤。根据尸检结果，她右肺合并有大细胞神经内分泌癌（LCNEC）和腺癌，两种成分均保留EGFR外显子19缺失。因此，向LCNEC的组织学转化可能是获得性EGFR-TKI耐药的一种机制。
