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Intestinal metastasis from primary ROS1-positive lung adenocarcinoma cancer patients responding to crizotinib

Authors Chen HF, Zhang QX, Zhu YC, Du KQ, Li XF, Wu LX, Wang WX, Xu CW

Received 3 July 2018

Accepted for publication 20 September 2018

Published 5 November 2018 Volume 2018:11 Pages 7821—7825

DOI https://doi.org/10.2147/OTT.S178985

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Prof. Dr. Jianmin Xu


Hua-fei Chen,1,* Qu-xia Zhang,2,* You-cai Zhu,1 Kai-qi Du,1 Xiao-feng Li,1 Li-xin Wu,1 Wen-xian Wang,3 Chun-wei Xu2

1Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, Jiaxing, Zhejiang, China; 2Department of Pathology, Fujian Cancer Hospital, Fujian Medical University Cancer Hospital, Fuzhou, Fujian, China; 3Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou, Zhejiang, China

*These authors contributed equally to this work

Abstract:
Small intestinal metastases from primary lung cancer are rare. Such patients have a poor prognosis. Early diagnosis of small intestinal metastases is difficult because of the low incidence of clinically apparent symptoms. The standard treatment for small intestinal metastases has not been established. A 69-year-old Chinese man presented for evaluation of a tumor in the right lower lung and mediastinal lymph node enlargement on clinical examination. The clinical stage was cT2N2M0 (stage IIIA). Histologic examination of the tumor revealed lung adenocarcinoma. He could not tolerate surgery; hence, he received two chemotherapy regimens. However, the disease progressed. He had bloating after chemotherapy and decreased flatus. An abdominal CT scan showed an intestinal effusion with local intestinal obstruction. Medical treatment was ineffective; hence, he underwent a diagnostic laparoscopy. The pathologic evaluation suggested an intestinal metastatic adenocarcinoma from the primary lung cancer. Based on an real-time PCR assay, the tumor had a ROS1 fusion and responded well to crizotinib. The progression-free survival was 7 months. Physicians must be aware of the possibility of intestinal metastases from primary lung cancer. With an accurate diagnosis and thorough evaluation, patients may benefit from targeted therapy.

Keywords: lung adenocarcinoma, ROS1, crizotinib, metastasis, small intestine

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