A Poorly Differentiated Malignant Neoplasm Lacking Lung Markers Harbors an EML4-ALK Rearrangement and Responds to Crizotinib

被引：12

作者：

Chung, Jon H. ^{[1
]}

Ali, Siraj M. ^{[1
]}

Davis, Jenni ^{[2
]}

Robstad, Karl ^{[2
]}

McNally, Richard ^{[3
]}

Gay, Laurie M. ^{[1
]}

Erlich, Rachel L. ^{[1
]}

Palma, Norma A. ^{[1
]}

Stephens, Phil J. ^{[2
]}

Miller, Vincent A. ^{[2
]}

Cutugno, Alfonso ^{[4
]}

Ross, Jeffrey S. ^{[1
,3
]}

机构：

[1] Fdn Med Inc, Cambridge, MA 02141 USA

[2] Albany Med Coll, Pathol Serv, Albany, NY 12208 USA

[3] Albany Med Coll, Albany, NY 12208 USA

[4] Cutugno Hematol Oncol, Kingston, NY 12401 USA

来源：

CASE REPORTS IN ONCOLOGY | 2014年 / 7卷 / 03期

关键词：

Crizotinib; ALK; Unknown primary tumor site; Poorly differentiated lung neoplasm;

D O I：

10.1159/000367780

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Suspected metastatic site lesions that are poorly differentiated present a diagnostic challenge when morphologic and immunohistochemical profiling cannot establish the primary tumor site. Here we present a patient diagnosed with both a malignant neoplasm in the lung and a right upper extremity (RUE) neoplasm of unclear histogenetic origin. Immunohistochemical staining performed on the latter specimen was inconclusive in determining the site of origin. Although the lung biopsy sample was insufficient for molecular testing, hybrid capture-based comprehensive genomic profiling (FoundationOne) identified an EML4-ALK rearrangement in the RUE lesion. Crizotinib treatment resulted in a major response in both the RUE and the lung lesions. This report illustrates the utility of comprehensive genomic profiling employed at the initial presentation of an unknown primary malignant neoplasm, which resulted in the front-line use of targeted therapy and a significant and sustained antitumor response. (C) 2014 S. Karger AG, Basel

引用

收藏

页码：628 / 632

页数：5

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