Ono Yuki, Takada Kazuki, Osoegawa Atsushi, Kinoshita Fumihiko, Oba Taro, Tsukamoto Shuichi, Tagawa Tetsuzo, Oda Yoshinao, Mori Masaki
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582 Japan.
Department of Thoracic Surgery, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
Int Cancer Conf J. 2020 Oct 16;10(1):78-82. doi: 10.1007/s13691-020-00453-z. eCollection 2021 Jan.
Leptomeningeal metastasis (LM) from lung cancer has poor prognosis, and effective therapy has not been established. We present the case of a 54-year-old man with LM from lung adenocarcinoma harboring L858R point mutation, who received osimertinib as first-line therapy. He had previously undergone left lower lobectomy and lymph node dissection for lung adenocarcinoma. Five years and 9 months after the operation, he developed symptoms of dizziness, lightheadedness, and headache. Magnetic resonance imaging showed high signal intensity in the cerebral sulcus and meninges, and cerebrospinal fluid (CSF) cytology indicated adenocarcinoma with L858R point mutation, which suggested LM. After CSF drainage and administration of corticosteroid and glycerol, the patient received osimertinib (80 mg/day) as first-line therapy. These symptoms including dizziness, lightheadedness, and headache were relieved and the MRI appearance was normal, and he survived for 19 months with no disease progression. Osimertinib is considered to be an effective therapeutic option for LM from lung adenocarcinoma harboring mutation.
肺癌的软脑膜转移（LM）预后较差，且尚未确立有效的治疗方法。我们报告了一例54岁男性，患有携带L858R点突变的肺腺癌软脑膜转移，接受奥希替尼作为一线治疗。他之前因肺腺癌接受了左下肺叶切除术和淋巴结清扫术。术后5年9个月，他出现头晕、头重脚轻和头痛症状。磁共振成像显示脑沟和脑膜高信号强度，脑脊液（CSF）细胞学检查显示为具有L858R点突变的腺癌，提示软脑膜转移。在进行脑脊液引流并给予皮质类固醇和甘油后，患者接受奥希替尼（80毫克/天）作为一线治疗。包括头晕、头重脚轻和头痛在内的这些症状得到缓解，MRI表现正常，他存活了19个月且无疾病进展。奥希替尼被认为是治疗携带该突变的肺腺癌软脑膜转移的有效治疗选择。
