Kawai Hitomi, Iguchi Kesato, Takayashiki Norio, Okauchi Shinichiro, Satoh Hiroaki
Division of Pathology, Mito Medical Center, University of Tsukuba-Mito Medical Center, Mito, Ibaraki, Japan.
Division of Surgery, Mito Medical Center, University of Tsukuba-Mito Medical Center, Mito, Ibaraki, Japan.
Acta Medica (Hradec Kralove). 2020;63(3):141-144. doi: 10.14712/18059694.2020.33.
Lung metastasis and metachronous double primary lung cancer are both common and often present diagnostic challenges. We present a case of metachronous isolated contralateral lung metastasis from pulmonary adenosquamous carcinoma with EGFR mutation. A 75-yearold woman presented with left lung nodule on a routine follow-up chest radiograph. She had had surgery for pulmonary adenocarcinoma with EGFR Ex21 L858R mutation 6 years ago. She underwent surgical resection, and histologic findings revealed adenosquamous carcinoma with the same EGFR mutation. Re-assessment of the resected specimen of the primary tumor resected 6 years ago revealed the morphologically similarity to the left lung tumor. Based on morphological and genetic identity, final diagnosis was adenosquamous cell carcinoma and metachronous isolated contralateral lung metastasis. The diagnosis of metachronous isolated metastasis is difficult but important for appropriate management and prediction of prognosis. A careful pathological examination and evaluation of genetic abnormality are needed to make the correct diagnosis.
肺转移和异时性双原发性肺癌都很常见，且常常带来诊断挑战。我们报告一例伴有EGFR突变的肺腺鳞癌异时性孤立性对侧肺转移病例。一名75岁女性在常规胸部X线随访检查时发现左肺结节。她6年前曾因EGFR Ex21 L858R突变的肺腺癌接受手术。她接受了手术切除，组织学检查结果显示为具有相同EGFR突变的腺鳞癌。对6年前切除的原发性肿瘤切除标本进行重新评估，发现其在形态学上与左肺肿瘤相似。基于形态学和基因一致性，最终诊断为腺鳞癌并异时性孤立性对侧肺转移。异时性孤立性转移的诊断困难，但对于恰当的治疗管理和预后预测很重要。需要进行仔细的病理检查和基因异常评估以做出正确诊断。
