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Vol.51 No.7 contents | Japanese/English |
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- Case Report -
A Case of Small-cell Lung Carcinoma with EGFR Gene Mutation
Sodai Narumi1, Akira Inoue1, Taizo Shibahara1, Ryotaro Igusa2, Tomohiro Sakakibara1, Toshihiro Nukiwa11Department of Respiratory Medicine, Tohoku University Graduate School of Medicine, Japan, 2Department of Internal Medicine, Osaki Citizen Hospital, Japan
Background. There are few reports of small-cell lung carcinoma (SCLC) with epidermal growth factor receptor (EGFR) gene mutation and the optimal treatment with EGFR-tyrosine kinase inhibitor (EGFR-TKI) for such patients has not yet been established. Case. A 74-year-old woman with dyspnea was referred to our hospital. A chest X-ray showed left pleural effusion and the mediastinum had shifted to the right. A chest CT image after drainage of her pleural effusion revealed a mass in the left lower lobe with destruction of the spine and ribs, and multiple other lesions (cT4N2M1b). The cytological diagnosis of SCLC was confirmed from pleural effusion specimens. Since SCLC is uncommon in non-smoking patients, we performed screening for EGFR mutations which revealed the presence of an exon 18 replacement mutation (G719C). Although first-line chemotherapy with carboplatin and etoposide was initially effective, her general condition worsened due to disease progression. Gefitinib was tried as a second-line therapy, but it was ineffective. Subsequent chemotherapy with amrubicin was also ineffective and the patient died. Conclusion. We encountered a case of SCLC with EGFR gene mutation in a non-smoker. The efficacy of EGFR-TKI for EGFR-mutated SCLC should be investigated further.
key words: Small-cell lung carcinoma, Epidermal growth factor receptor gene mutation, Epidermal growth factor receptor tyrosine kinase inhibitor, Gefitinib
Received: July 28, 2011
Accepted: October 5, 2011
JJLC 51 (7): 798-802, 2011
