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Vol.51 No.1 contents | Japanese/English |
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- Case Report -
A Case of Advanced Lung Adenocarcinoma with Paranasal Sinus Metastases, in Which Gefitinib Was Effective as First-line Therapy and Cyberknife® Was Efficacious for Local Control
Takeshi Honda1,2, Haruhiro Saito1, Shuji Murakami1, Chikako Hasegawa3, Takeshi Isobe2, Kouzo Yamada11Department of Thoracic Oncology, Kanagawa Cancer Center, Japan, 2Division of Clinical Oncology and Respiratory Medicine, Department of Internal Medicine, School of Medicine, Shimane University, Japan, 3Department of Pathology, Kanagawa Cancer Center, Japan
Background. Lung cancer usually metastasizes to multiple organs, but it is rare to find metastasis in the paranasal sinus cavities. In such cases, the prognosis is poor. We describe a patient with lung cancer in which paranasal sinus metastasis was detected. In this case, gefitinib, as first-line therapy, and Cyberknife®, for local control were effective. Patient. A 71-year-old man with nasal hemorrhage and exophthalmos was given a diagnosis of adenocarcinoma of the lung, which metastasized to the paranasal sinus cavity. We gave him gefitinib as first-line chemotherapy, because he tested positive for an epidermal growth factor receptor (EGFR) mutation (exon 21 point mutation). We used Cyberknife® therapy to treat his paranasal sinus metastases, and the lesions were controlled over the following 12 months. Gefitinib was withdrawn and erlotinib was begun because of progressive bone metastases. The patient is alive after 20 months. Conclusion. Paranasal sinus metastasis from lung cancer has a poor prognosis. However, in EGFR mutation-positive cases, long-term control of this disease is possible using gefitinib as first-line therapy and Cyberknife® for local control. However, cases in which gefitinib can be used as first-line therapy must be carefully selected.
key words: Gefitinib, Paranasal sinus metastasis, Lung cancer, EGFR mutation
Received: September 16, 2010
Accepted: November 26, 2010
JJLC 51 (1): 5-10, 2011
