Chen Yu-Qing, Li Yu-Fa, Zhang Chan-Yuan, Zhang Shi-Ling, Lv Zhi-Yi, Dong Song, Chen Hua-Jun, Zhang Xu-Chao, Wu Yi-Long, Yang Jin-Ji
School of Medicine, South China University of Technology, Guangzhou, People's Republic of China.
Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital and Guangdong Academy of Medical Sciences, Guangzhou, People's Republic of China.
JTO Clin Res Rep. 2021 Nov 19;2(12):100258. doi: 10.1016/j.jtocrr.2021.100258. eCollection 2021 Dec.
Pulmonary atypical carcinoid (PAC) is a rare subtype of pulmonary neuroendocrine neoplasm. Although fusion has been detected in PAC, mutations have not been reported before.
We performed hematoxylin and eosin staining, immunohistochemistry, and next-generation sequencing on tissues at baseline and after surgery.
The patient was diagnosed with having advanced PAC harboring the L858R mutation and then received a combination of icotinib and irinotecan plus cisplatin chemotherapy, achieving a partial response before the operation. Postoperative histology results revealed SCLC harboring the L858R mutation. Surprisingly, both the amplification and the deletion disappeared.
EGFR tyrosine inhibitors plus irinotecan plus cisplatin chemotherapy might be a potential treatment option for advanced pulmonary neuroendocrine neoplasms harboring mutations.
肺非典型类癌（PAC）是肺神经内分泌肿瘤的一种罕见亚型。尽管在PAC中已检测到 融合，但此前尚未报道过 突变。
我们对基线和手术后的组织进行了苏木精和伊红染色、免疫组织化学以及二代测序。
该患者被诊断为患有携带L858R突变的晚期PAC，随后接受了埃克替尼与伊立替康加顺铂联合化疗，术前达到部分缓解。术后组织学结果显示为携带L858R突变的小细胞肺癌。令人惊讶的是， 扩增和 缺失均消失了。
表皮生长因子受体酪氨酸抑制剂联合伊立替康加顺铂化疗可能是携带 突变的晚期肺神经内分泌肿瘤的一种潜在治疗选择。
