Abstract
We describe the case of a 72-year-old woman with locally advanced lung tumor mimicking primary lung cancer. She was diagnosed with rectal cancer at the age of 65 years and was initially treated with platinum-based chemotherapy and thoracic irradiation as a treatment for primary lung cancer. One year later, a thyroid tumor was detected in her right thyroid lobe and was confirmed to have metastasized from rectal cancer based on pathological findings. Therefore, we suspected that she had metachronous double cancers and treated her with conventional chemotherapy for colorectal cancer. However, new life-threatening multiple lung metastases appeared. We treated her with the drug erlotinib because additional genetic analysis against primary lung tumor revealed typical double-activating epidermal growth factor receptor mutations. Histological review by immunostaining concluded that the primary lung tumor was composed of metastatic tumors from rectal cancer. In addition, genetic analysis revealed that the primary rectal cancer contained nearly the same types of double-activating epidermal growth factor receptor mutations as were present in the lung tumor. This is the first report of a case of rectal adenocarcinoma with double-activating epidermal growth factor receptor mutations.
MeSH terms
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Adenocarcinoma / chemistry
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Adenocarcinoma / genetics
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Adenocarcinoma / secondary*
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Aged
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Antineoplastic Agents / therapeutic use*
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Antineoplastic Combined Chemotherapy Protocols / administration & dosage
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use
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Biomarkers, Tumor / analysis
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Biomarkers, Tumor / genetics
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Camptothecin / administration & dosage
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Camptothecin / analogs & derivatives
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Colorectal Neoplasms / chemistry
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Colorectal Neoplasms / genetics
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Colorectal Neoplasms / pathology*
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DNA Mutational Analysis
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ErbB Receptors / antagonists & inhibitors
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ErbB Receptors / genetics*
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Erlotinib Hydrochloride
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Female
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Fluorouracil / administration & dosage
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Humans
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Immunohistochemistry
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Leucovorin / administration & dosage
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Lung Neoplasms / chemistry
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Lung Neoplasms / drug therapy
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Lung Neoplasms / genetics
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Lung Neoplasms / secondary*
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Mutation*
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Neoplasms, Second Primary / diagnosis
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Organoplatinum Compounds / administration & dosage
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Quinazolines / therapeutic use*
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Thyroid Neoplasms / genetics
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Thyroid Neoplasms / secondary*
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Transcriptional Activation*
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Treatment Failure
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Treatment Outcome
Substances
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Antineoplastic Agents
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Biomarkers, Tumor
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Organoplatinum Compounds
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Quinazolines
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Erlotinib Hydrochloride
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ErbB Receptors
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Leucovorin
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Fluorouracil
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Camptothecin
Supplementary concepts
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Folfox protocol
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IFL protocol