EGFR-mutated Lung Adenocarcinoma with Choroidal Oligometastasis During Treatment with Gefitinib: a Case Report

Overview

Journal Int Cancer Conf J

Specialty Oncology

Date 2024 Jul 4

PMID 38962043

Authors

Takafumi Hashimoto

Atsushi Osoegawa

Miyuki Abe

Ryoko Oki

Takashi Karashima

Yohei Takumi

Kosuke Kamada

Michiyo Miyawaki

Kenji Sugio

Affiliations

Soon will be listed here.

Abstract

The patient was a 74-year-old woman who was diagnosed with lung adenocarcinoma, clinical Stage IIIA. Induction chemoradiation was performed followed by right upper lobectomy and lymph node dissection. Because of positive pleural effusion cytology, which was proven after surgery, the patient was diagnosed with pathological Stage IVA with EGFR L858R mutation. At 17 months after the administration of gefitinib, left choroidal metastasis appeared. Stereotactic irradiation and ruthenium small-beam radiation were effective; however, the metastatic lesion showed regrowth 7 months after these treatments. Because the patient's choroidal oligometastasis was resistant to conservative therapy, left ophthalmectomy was performed. EGFR mutations (L858R and E709K) were detected in the resected choroidal tumor. The patient continued to take gefitinib. However, a neoplastic lesion developed on the optic nerve adjacent to the resected posterior eye segment. The lesion was treated with stereotactic radiation, gefitinib was switched to afatinib 30 mg, and the patient remains alive and disease free for 11 months.

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