title: Solitary pulmonary metastasis from lung cancer harboring EML4-ALK after a 15-year disease-free interval.
abstract: It is often difficult to differentiate metachronous primary lung cancers from local pulmonary recurrences when the histopathological findings are similar. A 43-year-old man underwent right upper lobectomy with lymph node dissection for primary lung adenocarcinoma (p-T2aN0M0, stage IB). Fifteen years later, he developed a lung nodule in his right middle lobe. The tumor was preoperatively thought to be a metachronous second primary lung adenocarcinoma, and was surgically resected. Histopathological findings for both tumors were of poorly differentiated adenocarcinoma with mucus production. Both tumors also harbored the EML4 (echinoderm microtubule-associated protein-like 4)-ALK (anaplastic lymphoma kinase) fusion gene (variant 3a+b). Based on this molecular finding, the pulmonary nodule was considered to be a recurrence after very long latent period.
authors.affiliation: Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Tomizawa
authors.forename: Simon
authors.initials: S
authors.lastname: Ito
authors.forename: Kenichi
authors.initials: K
authors.lastname: Suda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Fukui
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Usami
authors.forename: Shunzo
authors.initials: S
authors.lastname: Hatooka
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Yatabe
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mitsudomi
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics* / Q000473:pathology; D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D008168:Lung / Q000378:metabolism* / Q000473:pathology; D008175:Lung Neoplasms / Q000235:genetics* / Q000473:pathology; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000235:genetics*; D015514:Oncogene Proteins, Fusion / Q000235:genetics*; D013997:Time Factors
chemical_list: C522504:EML4-ALK fusion protein, human; D015514:Oncogene Proteins, Fusion