title: [Cavitating nodules in a 40-year-old non-smoking woman: a very particular tumour].
abstract: BACKGROUND
  EML4-ALK fusion gene, is found in 3 to 5 % of lung adenocarcinoma and can be targeted by tyrosine-kinase inhibitor (TKI) with impressive therapeutic results.
  
  
  METHODS
  We report the case of a non-smoking 40-year-old woman, diagnosed with metastatic poorly differentiated papillary adenocarcinoma of the lung harbouring the ALK fusion gene. After six cycles of first line chemotherapy with cisplatine-vinorelbine followed by maintenance treatment with erlotinib, the patient achieved a partial response. After disease progression, the patient was included in a trial comparing crizotinib with a classic 2nd line chemotherapy. After 1 month of crizotinib, the patient's condition improved. CT of the chest showed a near-total regression of bilateral pulmonary nodules replaced by pulmonary cysts.
  
  
  CONCLUSIONS
  We report in this case a dramatic improvement with near-complete vanishing of pulmonary nodules replaced by pulmonary cysts in a patient treated with crizotinib. This case reminds us of the potential importance of evaluating the molecular diagnosis in lung cancers and especially in adenocarcinoma of the lung.
authors.affiliation: PCMAC Clinique de Pneumologie, CHU A. Michallon, BP 217X, 38043 Grenoble Cedex, France.
authors.forename: M-V
authors.initials: MV
authors.lastname: Albahary
authors.forename: G
authors.initials: G
authors.lastname: Ferretti
authors.forename: S
authors.initials: S
authors.lastname: Lantuejoul
authors.forename: A
authors.initials: A
authors.lastname: Mc Leer Florin
authors.forename: O
authors.initials: O
authors.lastname: Pop
authors.forename: A-C
authors.initials: AC
authors.lastname: Toffart
authors.forename: A
authors.initials: A
authors.lastname: Melis
authors.forename: A
authors.initials: A
authors.lastname: Goncalves
authors.forename: D
authors.initials: D
authors.lastname: Moro-Sibilot
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000077547:Crizotinib; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics; D015514:Oncogene Proteins, Fusion / Q000235:genetics; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011720:Pyrazoles / Q000008:administration & dosage / Q000627:therapeutic use; D011725:Pyridines / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: C522504:EML4-ALK fusion protein, human; D015514:Oncogene Proteins, Fusion; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011725:Pyridines; D000077547:Crizotinib