title: Rare co-existence of mutation in KRAS and ALK gene re-arrangement in an adenocarcinoma patient--a case report.
abstract: Anaplastic lymphoma kinase (ALK) gene re-arrangements are present in approximately 4% of patients with non-small cell lung cancer (NSCLC), mostly in non-smokers with adenocarcinoma. V-KI-RAS2 Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations are more common in smokers. These molecular lesions were usually described as are mutually exclusive. We herein describe a rare case of co-existence of ALK and KRAS abnormalities in adenocarcinoma tumor with massive local growth (disproportionality of clinical symptoms) and rapid central nervous system (CNS) metastases spread. T3N1M0 stage tumor (size: 10×12×13 cm) in upper lobe of the right lung was diagnosed in a 56-year-old Caucasian male smoker. Adenocarcinoma of solid predominant was surgically resected with chest wall reconstruction. One month after surgery, CNS metastases were diagnosed and subsequently treated with radiotherapy. We noted an 8-month overall survival from tumor resection. In the case of comorbidity of disorders in the ALK (uncertain prognostic significance) and KRAS gene (described as unfavorable prognostic factor), these abnormalities may ultimately decide the course of the disease in the form of brain metastases.
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland iwona.homa@wp.pl.
authors: Iwona
authors: I
authors: Homa
authors: Department of Thoracic Surgery, Medical University of Lublin, Lublin, Poland.
authors: Marek
authors: M
authors: Sawicki
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.
authors: Kamila
authors: K
authors: Wojas-Krawczyk
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland Postgraduate School of Molecular Medicine, Medical University of Warsaw, Warsaw, Poland.
authors: Marcin
authors: M
authors: Nicoś
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland Department of Human Physiology, Medical University of Lublin, Lublin, Poland.
authors: Radosław
authors: R
authors: Mlak
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.
authors: Tomasz
authors: T
authors: Powrózek
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland.
authors: Paweł
authors: P
authors: Krawczyk
authors: Department of Radiology, Medical University of Lublin, Lublin, Poland.
authors: Piotr
authors: P
authors: Przybylski
authors: Department of Radiology, Medical University of Lublin, Lublin, Poland.
authors: Elżbieta
authors: E
authors: Czekajska-Chehab
authors: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland Human Physiology, Medical University of Lublin, Lublin, Poland.
authors: Janusz
authors: J
authors: Milanowski
mesh_terms: D000230:Adenocarcinoma / Q000235:genetics*; D000077192:Adenocarcinoma of Lung; D000077548:Anaplastic Lymphoma Kinase; D015321:Gene Rearrangement; D011905:Genes, ras; D006801:Humans; D008175:Lung Neoplasms / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011518:Proto-Oncogene Proteins / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras); D020794:Receptor Protein-Tyrosine Kinases / Q000235:genetics*; D012907:Smoking / Q000009:adverse effects / Q000235:genetics; D018631:ras Proteins / Q000235:genetics
chemical_list: C117307:KRAS protein, human; D011518:Proto-Oncogene Proteins; C000626173:ALK protein, human; C000626175:Alk protein, rat; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases; D016283:Proto-Oncogene Proteins p21(ras); D018631:ras Proteins
keywords: ALK rearrangement; CNS metastases; KRAS mutation; lung adenocarcinoma