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Abstract

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Article in Japanese

Case Report

Synchronous multiple lung cancer with EGFR mutation-positive and EGFR mutation-negative lung adenocarcinoma

Tomohiro Nakayamaa  Yusuke Amanoa  Misa Sugiyamaa  Shusuke Yazawaa  Koshi Yokomuraa  Takahumi Sudab 

aDepartment of Respiratory Medicine, Seirei Mikatahara General Hospital
bSecond Division, Department of Internal Medicine, Hamamatsu University School of Medicine

ABSTRACT

A 71-year-old woman presented with nodules in the right and left upper lung lobes with left pleural effusion. Pleural effusion cytology revealed adenocarcinoma. The left upper lung lobe adenocarcinoma was cT1aN0M1a (PLE) stage IVA and EGFR mutation-positive (exon 19 deletion). Afatinib treatment reduced the left upper lobe nodule and left pleural effusion. However, the right upper lobe nodule increased, and liver metastasis occurred. Histopathologically, the liver biopsy revealed metastasis from lung adenocarcinoma with more poorly differentiated malignant cells than those observed on pleural effusion cytology. The tumor showed high levels of PD-L1. EGFR mutation was not detected. After cytotoxic anticancer drug treatment, pembrolizumab treatment reduced the right upper lobe nodule and liver metastasis. However, the pleural effusion increased again. After cytotoxic anticancer drug treatment, afatinib treatment reduced the left pleural effusion.

KEYWORDS

Synchronous multiple lung cancer  EGFR mutation-positive lung cancer  EGFR tyrosine kinase inhibitor (EGFR-TKI)  Immune checkpoint inhibitor (ICI) 

Received 20 Feb 2020 / Accepted 12 Oct 2020

AJRS, 10(1): 50-54, 2021

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