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[Multiple pulmonary nodules with interstitial changes].

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|August 4, 2022

Summary

This summary is machine-generated.

A 53-year-old female with advanced lung adenocarcinoma and a venous thromboembolic event showed significant improvement with sequential ALK inhibitors crizotinib and alectinib. This case highlights effective treatment for ALK-positive lung cancer with metastasis.

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Published on: May 23, 2015

Area of Science:

Oncology
Pulmonology
Genetics

Background:

A 53-year-old female presented with a 4-month history of worsening cough, sputum, and dyspnea on exertion.
Initial imaging over 2.5 years showed stable pulmonary nodules, followed by significant interval growth and interstitial changes.

Observation:

The patient experienced a venous thromboembolic event (VTE) with elevated D-dimer upon admission.
Diagnostic workup included bronchoscopy, gastroscope, PET-CT, and MRI, revealing lung adenocarcinoma with extensive metastasis.

Findings:

Pathological diagnosis confirmed lung adenocarcinoma (solid, mucus-secreting) with mediastinal, hilar, intrapulmonary, and gastric metastasis.
Genetic analysis revealed a positive EML4-ALK fusion gene in both lung and stomach tissues.
The patient responded well to sequential treatment with crizotinib and alectinib, along with anticoagulation.

Implications:

This case demonstrates the efficacy of sequential ALK tyrosine kinase inhibitors in managing advanced, metastatic ALK-positive lung adenocarcinoma.
Early detection and management of VTE are crucial in patients with advanced lung cancer.
Targeted therapy offers a favorable prognosis, maintaining quality of life for patients with complex oncological presentations.