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Vol.56 No.7 contents | Japanese/English |
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- Case Report -
Chest Wall Metastasis of Anaplastic Lymphoma Kinase-positive Lung Adenocarcinoma 22 Years After Lobectomy
Daisuke Matsumoto1, Hiromitsu Takizawa1, Mika Takashima1, Yukikiyo Kawakami1, Kazuya Kondo1, Akira Tangoku11Department of Thoracic, Endocrine Surgery and Oncology, Tokushima University Graduate School, Japan
Background. When a new tumor appears after a long period of remission following surgery for lung cancer, it is difficult to determine whether the tumor is a recurrence or a new tumor. We herein report a case of a chest wall tumor that developed 22 years after pulmonary lobectomy diagnosed by an anaplastic lymphoma kinase (ALK) gene mutation. Case. An 80-year-old man underwent left-lung upper lobectomy for lung adenocarcinoma (pT4N2M0 Stage III) 22 years prior. We treated him with adjuvant chemotherapy after the surgery and did not detect a recurrence for 10 years. However, we noticed a chest wall mass 22 years after the surgery and diagnosed it by a biopsy as adenocarcinoma. The new specimen was stained with anti-thyroid transcription factor-1 (TTF-1) and anti-ALK antibodies, and the pathological specimen from the first surgery was also stained with anti-ALK antibody. We therefore diagnosed the chest wall tumor as a recurrence of the lung adenocarcinoma. We treated him with crizotinib, and the tumor shrank. However, we stopped the treatment because of the development of drug-induced interstitial pneumonia. We switched him to a platinum combination regimen, and follow-up is ongoing. Conclusions. When a lesion is suspected to be a recurrence long after surgery, an examination of gene mutations, such as that of ALK, may be useful.
key words: Lung cancer, ALK, Late recurrence
Received: May 19, 2016
Accepted: August 14, 2016
JJLC 56 (7): 1046-1050, 2016
