Targeted therapy of multiple liver metastases after resected solitary gastric metastasis and primary pulmonary adenocarcinoma.
Gastric metastases from lung adenocarcinoma are rare and usually asymptomatic. A 61-year-old woman was referred to our department because of a right lower pulmonary mass found on a chest X-ray film in August 2012. Right lower lobectomy was performed for pulmonary adenocarcinoma. Four months later, she developed epigastric discomfort. A fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG-PET/CT) scan showed a malignancy at the cardias of the stomach. A biopsy diagnosed poorly differentiated carcinoma and a gastric carcinoma was suspected. She underwent a subtotal gastrectomy and part of esophagectomy. The histologic diagnosis was metastasis from the pulmonary adenocarcinoma. She visited us again for her increasing level of carcinoembryonic antigen (CEA) after two months. FDG-PET/CT showed multiple malignant lesions in her liver, considering metastases from pulmonary origin. As she harbored activating epidermal growth factor receptor (EGFR) mutation, she received erlotinib from April, 2013. She survives 4 years after the lung resection and is still on erotinib treatment with complete response. Although gastric metastasis from lung cancer is considered a late stage of the disease, a radical resection might provide survival in solitary metastasis. Moreover, systemic therapy was emphasized after local treatment in some late stage cases.
Department of Medical Oncology, Hangzhou Cancer Hospital, Hangzhou, China.|Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Ling-Yu
LY
Ding
Department of Medical Oncology, Dongguan People's Hospital, Dongguan, China.
Ke-Jun
KJ
Liu
Department of Emergency, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou, China.
Zhe-Long
ZL
Jiang
Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center of Cancer Medicine, Guangzhou, China.
Hai-Ying
HY
Wu
Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, China.
Shi-Xiu
SX
Wu
D000230:Adenocarcinoma / Q000473:pathology*; D000077192:Adenocarcinoma of Lung; D066246:ErbB Receptors / Q000235:genetics; D000069347:Erlotinib Hydrochloride / Q000627:therapeutic use; D005260:Female; D019788:Fluorodeoxyglucose F18; D005743:Gastrectomy; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary*; D008175:Lung Neoplasms / Q000473:pathology*; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D013274:Stomach Neoplasms / Q000556:secondary* / Q000601:surgery
D019788:Fluorodeoxyglucose F18; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors
gastric metastasis; liver metastases; lung cancer; surgery; targeted therapy