Amylase-Producing Lung Cancer with a Positive Epidermal Growth Factor Receptor Mutation Treated With Gefitinib: A...

A 60-year-old woman was diagnosed with metastatic pulmonary adenocarcinoma (c-stage IV) with an L858R point mutation in the gene encoding epidermal growth factor receptor (EGFR). Serum amylase levels were elevated (1,531 IU/L) with the salivary-type enzyme dominating. First-line chemotherapy using carboplatin plus paclitaxel reduced serum amylase levels, although second-line gefitinib eventually failed to control tumor growth and hyperamylasemia after 4.5 months of treatment. The cancer cells harbored a positive EGFR mutation and secreted amylase. The number of amylase-producing cancer cells and the immunochemical staining intensity for amylase were significantly reduced after gefitinib treatment. This was a rare case of a lung cancer that expressed amylase and harbored a positive EGFR mutation.