Ovarian metastases from ALK-positive lung adenocarcinoma: a case report and review of the literature.
Ovarian metastases from ALK-positive lung adenocarcinoma: a case report and review of the literature.
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ALK 阳性肺腺癌卵巢转移：病例报告及文献复习
DOI：
10.21037/tcr-22-273
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发表时间：
2022-09
影响因子：
0.9
通讯作者：
中科院分区：
文献类型：
--
作者：
背景：在肺腺癌患者中，卵巢转移是一种极其罕见的情况。肺腺癌卵巢转移患者与原发卵巢癌难以鉴别。间变性淋巴瘤激酶(ALK)基因重排仅见于3-7%的肺癌患者。值得注意的是，肺癌合并卵巢转移的发生率极低，然而，ALK重排在这些病例中经常被报道。我们在此报告一位年轻女性，年龄23岁，患有ALK阳性肺腺癌和卵巢转移。病例描述：患者在意外发现腹部肿块后，接受了腹腔镜双侧卵巢肿瘤切除术。术后用免疫组织化学(IHC)法检测一系列肺腺癌特异性免疫组织化学特征。2-脱氧-2-[18F]氟-d-葡萄糖(18F-FDG)正电子发射断层扫描结合低剂量计算机断层扫描(PET/CT)发现不同大小的广泛期转移肿块，其中最大的结节位于右肺中叶1.7 cm×1.4 cm。石蜡组织DNA基因检测发现EML4_ALK(E14：A20)基因发生融合突变。患者被病理诊断为肺腺癌合并双侧卵巢转移，服用阿来替尼[每日两次，每次600毫克]，每季度随访一次。目前，患者对阿莱替尼的反应稳定，无进展生存期(PFS)超过12个月，没有发生重大不良事件。此外，我们还回顾了与ALK阳性肺癌卵巢转移的特点以及原发和继发卵巢肿瘤的鉴别相关的文献。结论本病例对肺癌附件转移的可能性提供了有意义的参考，特别是对于ALK重排的年轻女性患者。此外，该病例突出了免疫组化结合基因检测在识别卵巢转移瘤起源部位方面的优势，并提供了一种有前景的治疗方案。
Background Ovarian metastasis is an extremely rare condition in patients with lung adenocarcinoma. Lung adenocarcinoma patients with ovarian metastases were difficult to distinguish from primary ovarian cancer. Anaplastic lymphoma kinase (ALK) gene rearrangement is only found in 3–7% of patients with lung cancer. It is worth noting that the incidence of lung cancer with ovarian metastasis is extremely low, however, ALK rearrangement is often reported in these cases. Here we reported a young woman, aged 23 years, with ALK-positive lung adenocarcinoma and ovarian metastasis. Case Description The patient underwent laparoscopic bilateral ovarian tumor resection after discovering an abdominal mass accidentally. A series of lung adenocarcinoma-specific immunohistochemical features were detected postoperatively by immunohistochemistry (IHC) analysis. Then extensive-stage metastatic masses of different sizes were identified by 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) positron emission tomography combined with low-dose computed tomography (PET/CT), among which the largest nodule was 1.7 cm × 1.4 cm located in the middle lobe of the right lung. Genetic testing of the paraffin tissue DNA revealed the fusion mutation of EML4_ALK (E14:A20) gene. The patient was pathologically diagnosed with lung adenocarcinoma with bilateral ovarian metastasis, administered with oral alectinib [600 mg twice daily (bid)] and followed-up quarterly. Currently, the patient responded to alectinib stably, with a progression-free survival (PFS) of more than 12 months, and experienced no significant adverse events. In addition, we reviewed the publications associated with the characteristics of ALK-positive lung cancer with ovarian metastases and the identification of primary and secondary ovarian tumors. Conclusions This case provides a meaningful reference for the possibility of adnexal metastases from lung cancer, particularly for ALK-rearranged young female patients. In addition, this case highlights the advantages of IHC together with genetic testing for identifying origin sites of ovarian metastases and provides a promising treatment option.
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DOI：
10.1200/jco.2017.76.2294
发表时间：
2018-04-20
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
--
作者：
Lin JJ;Zhu VW;Yoda S;Yeap BY;Schrock AB;Dagogo-Jack I;Jessop NA;Jiang GY;Le LP;Gowen K;Stephens PJ;Ross JS;Ali SM;Miller VA;Johnson ML;Lovly CM;Hata AN;Gainor JF;Iafrate AJ;Shaw AT;Ou SI
通讯作者：
Ou SI
影响因子：
7.5
作者：
Chu, PG;Wu, E;Weiss, LM
通讯作者：
Weiss, LM
影响因子：
19.7
作者：
Brown, DL;Zou, KH;Kurtz, AB
通讯作者：
Kurtz, AB
影响因子：
158.5
作者：
Peters, Solange;Camidge, D. Ross;Mok, Tony
通讯作者：
Mok, Tony
影响因子：
4.7
作者：
Antila, R;Jalkanen, J;Heikinheimo, O
通讯作者：
Heikinheimo, O