title: Recurrent EML4-ALK-associated lung adenocarcinoma with a slow clinical course.
abstract: The fusion gene EML4-ALK (echinoderm microtubule-associated protein-like 4 gene and the anaplastic lymphoma kinase gene) was recently identified as a novel genetic alteration in non-small-cell lung cancer. The clinicopathological features of EML4-ALK-positive adenocarcinoma are reported to include its high incidence in young, non-smoking patients, tumors that show distinct solid or acinar growth patterns with or without signet-ring cell histology, and its mutually exclusive occurrence with mutations in EGFR and KRAS. However, the clinical findings have not been well described. Here, we report a case of EML4-ALK-positive lung adenocarcinoma that showed multiple metachronous lesions on the pleura and pulmonary field, suspected to be a recurrence of lung adenocarcinoma after a 20-year disease-free interval. The slow clinical course may be characteristic of EML4-ALK-positive lung adenocarcinoma. Therefore, long-term observation of patients with EML4-ALK-positive lung adenocarcinomas is required after surgery.
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center Hospital, Nakao 1-1-2, Asahi-ku, Yokohama, Kanagawa 241-0815, Japan. murakamis@kcch.jp
authors.forename: Shuji
authors.initials: S
authors.lastname: Murakami
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yokose
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Saito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Shoichi
authors.initials: S
authors.lastname: Matsukuma
authors.forename: Chikako
authors.initials: C
authors.lastname: Hasegawa
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kondo
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Oshita
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.forename: Masahiro
authors.initials: M
authors.lastname: Tsuboi
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Nakayama
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kameda
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Noda
authors.forename: Kouzo
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D014408:Biomarkers, Tumor / Q000235:genetics; D003937:Diagnosis, Differential; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D009154:Mutation / Q000235:genetics; D009364:Neoplasm Recurrence, Local; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D010997:Pleural Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology / Q000503:physiopathology; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D013997:Time Factors; D014057:Tomography, X-Ray Computed; D018631:ras Proteins / Q000235:genetics
chemical_list: D014408:Biomarkers, Tumor; C522504:EML4-ALK fusion protein, human; C117307:KRAS protein, human; D015514:Oncogene Proteins, Fusion; D011518:Proto-Oncogene Proteins; C512478:EGFR protein, human; D066246:ErbB Receptors; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins