title: Bilateral ovarian metastasis of non-small cell lung cancer with ALK rearrangement.
abstract: The discovery of a distinct subtype of non-small cell lung cancer (NSCLC) positive for rearrangement of the anaplastic lymphoma kinase gene (ALK) has had a substantial impact on personalized therapy for this disease. The clinical features associated with metastasis in individuals with ALK rearrangement-positive NSCLC remain to be fully characterized, however. We now describe a case of ovarian metastasis from NSCLC with ALK rearrangement. A 39-year-old woman underwent a right middle lobectomy for acinar-type adenocarcinoma of the lung (pT2aN2M0, stage IIIA). Fluorescence in situ hybridization (FISH) analysis of the resected tumor tissue revealed the presence of an ALK rearrangement. Twenty months later, a large intrapelvic mass was detected in the patient at follow-up. She underwent both left salpingo-oophorectomy and right ovarian cystectomy. Histological examination of the ovarian tumors showed acinar adenocarcinoma, and FISH analysis revealed the presence of ALK rearrangement, confirming a diagnosis of ALK rearrangement-positive NSCLC with ovarian metastasis. Although the ovary is an uncommon site for metastasis from lung cancer, physicians should be aware of the possibility for such metastasis during follow-up for female patients with ALK rearrangement-positive NSCLC. Further investigation is warranted to clarify the incidence of ovarian metastasis in NSCLC patients with ALK rearrangement.
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, 537-8511, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Fujiwara
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, 537-8511, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Higashiyama
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, 537-8511, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanou
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, 537-8511, Japan.
authors.forename: Toshiteru
authors.initials: T
authors.lastname: Tokunaga
authors.affiliation: Department of Thoracic Surgery, Osaka Medical Center for Cancer and Cardiovascular Disease, Osaka, 537-8511, Japan.
authors.forename: Jiro
authors.initials: J
authors.lastname: Okami
authors.affiliation: Department of Surgery, Yao Municipal Hospital, Osaka 581-0069, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Kodama
authors.affiliation: Department of Respiratory Medicine, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Nishino
authors.affiliation: Department of Pathology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka 537-8511, Japan.
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Tomita
authors.affiliation: Department of Medical Oncology, Kinki University Faculty of Medicine, Osaka 589-8511, Japan; Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka 812-8582, Japan. Electronic address: okamotoi@kokyu.med.kyushu-u.ac.jp.
authors.forename: Isamu
authors.initials: I
authors.lastname: Okamoto
mesh_terms: D061354:Acinar Cells / Q000473:pathology; D000328:Adult; D000077548:Anaplastic Lymphoma Kinase; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000556:secondary; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008991:Monitoring, Physiologic; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000556:secondary; D011013:Pneumonectomy; D057285:Precision Medicine; D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*
chemical_list: C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases
keywords: ALK rearrangement; Non-small cell lung cancer; Ovarian metastasis