Targeted therapy of multiple liver metastases after resected solitary gastric metastasis and primary pulmonary adenocarcinoma
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Ling-yu Ding1,2,3,4, Ke-jun Liu5, Zhe-long Jiang6, Hai-ying Wu2,3,4, Shi-xiu Wu7
1Department of Medical Oncology, Hangzhou Cancer Hospital, Hangzhou, China
2Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China
3State Key Laboratory of Oncology in South China, Guangzhou, China
4Collaborative Innovation Center of Cancer Medicine, Guangzhou, China
5Department of Medical Oncology, Dongguan People’s Hospital, Dongguan, China
6Department of Emergency, Hangzhou First People’s Hospital, Nanjing Medical University, Hangzhou, China
7Department of Radiation Oncology, Hangzhou Cancer Hospital, Hangzhou, China
Shi-xiu Wu, email: [email protected]
Keywords: lung cancer, gastric metastasis, surgery, liver metastases, targeted therapy
Received: March 10, 2016 Accepted: October 31, 2016 Published: November 04, 2016
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.
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