Komura Moegi, Yagishita Shigehiro, Nakamura Kota, Arano Naoko, Takeshige Tomohito, Muraki Keiko, Nagashima Osamu, Izumi Hiroshi, Tomita Shigeki, Sasaki Shinichi, Takahashi Kazuhisa
Department of Respiratory Medicine, Juntendo University Urayasu Hospital, Urayasu, Japan.
Division of Respiratory Medicine, Juntendo University Faculty of Medicine and Graduate School of Medicine, Tokyo, Japan.
In Vivo. 2018 Sep-Oct;32(5):1205-1209. doi: 10.21873/invivo.11365.
A 28-year-old woman who was 34 weeks pregnant was admitted with complaints of cough and blood-stained sputum. After delivery of the baby at 37 weeks gestation, computed tomography and magnetic resonance imaging revealed a tumor in the right lung and a 15-mm brain metastasis. A diagnosis of lung adenocarcinoma was made, cT4N3M1b (stage IV disease) by pleural fluid cytology. Additional testing for anaplastic lymphoma kinase (ALK) fusion protein showed a strongly positive result, which was then confirmed by fluorescence in situ hybridization. The patient was started on treatment with alectinib, and the tumor and brain metastasis had almost vanished by 2 months after the start of this treatment. In the literature, there are 59 reports of lung cancer diagnosed during pregnancy, including two cases of cancer with expression of ALK fusion protein and five cases showing epidermal growth factor receptor mutation. The type of mutation should be taken into consideration while selecting for the appropriate therapeutic strategy.
一名28岁、怀孕34周的女性因咳嗽和痰中带血入院。在妊娠37周分娩后，计算机断层扫描和磁共振成像显示右肺有一个肿瘤以及一个15毫米的脑转移瘤。通过胸水细胞学检查诊断为肺腺癌，cT4N3M1b（IV期疾病）。间变性淋巴瘤激酶（ALK）融合蛋白的进一步检测显示结果呈强阳性，随后通过荧光原位杂交得到证实。患者开始接受阿来替尼治疗，在开始治疗2个月后，肿瘤和脑转移瘤几乎消失。在文献中，有59例关于孕期诊断为肺癌的报告，其中包括2例ALK融合蛋白表达阳性的癌症病例和5例表皮生长因子受体突变病例。在选择合适的治疗策略时应考虑突变类型。
