Coexistence of an EGFR Mutation and an ALK Rearrangement in a Patient with Lung Adenocarcinoma: a Case Report

Min Ah Kim, Jin-Hyoung Kang, In-Ho Kim, Tae-Jung Kim, Seung Joon Kim, Sook Whan Sung, Sol Mi Huo
2016 Korean Journal of Medicine  
A 58 year-old woman was diagnosed with lung adenocarcinoma (cT3N1M0). We detected a point mutation in epidermal growth factor receptor (EGFR) exon 21 (L858R) and an echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase (ALK) rearrangement. The patient was treated with preoperative neoadjuvant chemotherapy and underwent a left lower lobectomy with mediastinal lymph node dissection. However, we could not detect any mutation in EGFR or the ALK rearrangement from the tumor
more » ... from the tumor tissue removed. Then, 70 days after completion of adjuvant chemotherapy, she visited our outpatient clinic with diminished visual accuracy and tinnitus. A single brain metastatic lesion was seen on brain magnetic resonance imaging. She underwent surgical removal of the brain mass, which showed a mutation of EGFR, exon 21, but no ALK rearrangement. We report this unusual case of lung adenocarcinoma with a coexisting EGFR mutation and ALK rearrangement, and identify gene alterations before chemotherapy, after chemotherapy, and at recurrence. (Korean J Med 2016;90:72-77)
doi:10.3904/kjm.2016.90.1.72 fatcat:tir2p4lhnrc6dpesxr5c5yijpi