Diagnosis and management of a metastatic mixed gestational trophoblastic neoplasia with synchronous primary lung cancer

2021 ◽  
Vol 14 (5) ◽  
pp. e240606
Author(s):  
Varun Iyengar ◽  
Hetal Mistry ◽  
Catherine Hibbitt ◽  
Alexei Shimanovsky
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Combination Chemotherapy ◽  
Primary Lung Cancer ◽  
Pulmonary Nodules ◽  
Holistic Care ◽  
Gestational Trophoblastic Neoplasia ◽  
Primary Lung Adenocarcinoma ◽  
Rare Tumours

Mixed gestational trophoblastic neoplasias (GTNs) are rare placental tumours that arise from abnormal fertilisation events. To date, only 34 patients with mixed GTNs have been reported in the literature. As such, the management of such cases remains challenging. This report presents a case of a mixed GTN that was further complicated by a synchronous primary lung adenocarcinoma. Our patient was initially treated with hysterectomy, with surveillance labwork showing persistence of her malignancy. She then began combination chemotherapy, at the end of which she appeared to be in remission clinically. Unfortunately, subsequent imaging showed the persistence of pulmonary nodules that were ultimately resected, demonstrating a new primary lung adenocarcinoma. At present, she remains free of both cancers 2 years after her initial diagnosis. The complexity of this case underscores the importance of patient-centred treatment for rare tumours and the role of a multidisciplinary team in the effort to provide holistic care.

scholarly journals Detection of EGFR Mutation of Pulmonary Adenocarcinoma in Sputum using Droplet Digital PCR

2021 ◽  
Author(s):  
Tetsuya Isaka ◽  
Tomoyuki Yokose ◽  
Hiroyuki Ito ◽  
Haruhiko Nakayama ◽  
Yohei Miyagi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Tumor Size ◽  
Mutation Detection ◽  
Egfr Mutation ◽  
Lung Tumor ◽  
Primary Lung Cancer ◽  
Resected Specimen ◽  
Sputum Cytology ◽  
Primary Lung Adenocarcinoma

Abstract Background】It is still unclear whether epidermal growth factor receptor (EGFR) mutation of primary lung adenocarcinoma can be detected accurately on sputum samples. This study aimed to examine EGFR mutations of primary lung adenocarcinoma in sputum samples using droplet digital polymerase chain reaction (ddPCR) and compare it with an EGFR mutation in surgically resected lung cancer. 【Methods】Sputum was collected preoperatively from patients with primary lung cancer who were scheduled for complete resection of lung tumor at Kanagawa Cancer Center from September 2014 to May 2016. ddPCR was performed to detect EGFR exon 21 L858R point mutation (Ex21 mutation) and EGFR exon 19 deletion mutation (Ex19 mutation) in the sputum samples. The concordance of EGFR mutation status in sputum samples and tumors in surgically resected specimen was evaluated for each positive and negative cytology group.【Results】One hundred and eighteen patients with primary lung adenocarcinoma provided sputum samples. Sputum cytology was positive in 13 patients (11.0%). ddPCR detected two cases of Ex21 mutation and two cases of Ex19 mutation. Compared to surgically resected specimens, the sensitivity, specificity, and positive predictive value of EGFR mutation detection were 80.0%, 100%, and 92.3%, respectively. The sensitivity of EGFR mutation detection was 3.1% in sputum cytology negative cases. Logistic regression model analysis revealed that tumor size ≥ 29 mm determined using computed tomography (CT) was an independent potential predictive factor for positive sputum cytology (odds ratio = 10.6, 95% confidence interval: 1.85–61.0, p=0.008).【Conclusions】EGFR mutation of primary lung adenocarcinoma was accurately detected in sputum samples using ddPCR if the sputum cytology was positive. Sputum samples should be collected in patients with CT tumor size ≥ 29 mm for EGFR mutation analysis.

scholarly journals Secondary Primary Lung Cancer After Esophageal Cancer: A Population-Based Study of 44,172 Patients

2020 ◽  
Author(s):  
Yadong Gao ◽  
Jianwei Qiu ◽  
Liugen Gu ◽  
Yanmei Yang ◽  
Haifeng Kang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Esophageal Cancer ◽  
Lung Adenocarcinoma ◽  
Primary Lung Cancer ◽  
Squamous Carcinoma ◽  
Primary Lung Adenocarcinoma ◽  
Significant Difference ◽  
History Of ◽  
Lung Squamous Carcinoma

Abstract Background: The present study aimed to assess the incidence, characteristics, and survival of secondary primary lung cancer after primary esophageal cancer (EC-LC). Methods: The patients with esophageal cancer (EC) who developed SPLC and patients with first primary lung cancer (LC-1) were retrospectively reviewed in the Surveillance, Epidemiology, and End Results 18 registries covering 2000 to 2016. The risk of secondary primary lung cancer using standardized incidence ratio (SIR) was calculated among patients with EC. Overall survival and characteristics were compared between patients with EC-LC and patients with LC-1.Results: In comparison with the general population, the patients with EC had a higher risk for developing secondary primary lung cancer (SIR =1.86, 95% confidence interval (CI): 1.69-2.05). There was a significant difference with regard to the year of diagnosis, sex, grade and stage between the secondary primary lung squamous carcinoma after EC (EC-LUSC) and first primary lung squamous carcinoma (LUSC-1) patients. A statistically significant difference with respect to race, sex, age, year, grade and stage was found between the secondary primary lung adenocarcinoma after EC (EC-LUAD) and first primary lung adenocarcinoma (LUAD-1) patients. A history of EC was found to be an independent risk factor of death for lung squamous carcinoma and lung adenocarcinoma patients in localized stage based on multivariate Cox regression analysis, propensity score-matching analysis and multiple imputation.Conclusion: There is a significantly increased risk of secondary primary lung cancer in EC survivors and a history of EC adversely affects overall survival in individuals who subsequently develop localized EC-LUSC and EC-LUAD. Clinicians should moderately strengthen lung tissue protection during the management of EC patients.

scholarly journals Detection of EGFR Mutation of Pulmonary Adenocarcinoma in Sputum Using Droplet Digital PCR

2020 ◽  
Author(s):  
Tetsuya Isaka ◽  
Tomoyuki Yokose ◽  
Hiroyuki Ito ◽  
Haruhiko Nakayama ◽  
Yohei Miyagi ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Tumor Size ◽  
Mutation Detection ◽  
Egfr Mutation ◽  
Lung Tumor ◽  
Primary Lung Cancer ◽  
Resected Specimen ◽  
Sputum Cytology ◽  
Primary Lung Adenocarcinoma

Abstract Background It is still unclear whether epidermal growth factor receptor (EGFR) mutation of primary lung adenocarcinoma can be detected accurately on sputum samples. This study aimed to examine EGFR mutations of primary lung adenocarcinoma in sputum samples using droplet digital polymerase chain reaction (ddPCR) and compare it with an EGFR mutation in surgically resected lung cancer. Methods Sputum was collected preoperatively from patients with primary lung cancer who were scheduled for complete resection of lung tumor at Kanagawa Cancer Center from September 2014 to May 2016. ddPCR was performed to detect EGFR exon 21 L858R point mutation (Ex21 mutation) and EGFR exon 19 deletion mutation (Ex19 mutation) in the sputum samples. The concordance of EGFR mutation status in sputum samples and tumors in surgically resected specimen was evaluated for each positive and negative cytology group.Results One hundred and eighteen patients with primary lung adenocarcinoma provided sputum samples. Sputum cytology was positive in 13 patients (11.0%). ddPCR detected two cases of Ex21 mutation and two cases of Ex19 mutation. Compared to surgically resected specimens, the sensitivity, specificity, and positive predictive value of EGFR mutation detection were 80.0%, 100%, and 92.3%, respectively. The sensitivity of EGFR mutation detection was 3.1% in sputum cytology negative cases. Logistic regression model analysis revealed that tumor size ≥ 29 mm determined using computed tomography (CT) was an independent potential predictive factor for positive sputum cytology (odds ratio = 10.6, 95% confidence interval: 1.85–61.0, p=0.008).Conclusions EGFR mutation of primary lung adenocarcinoma was accurately detected in sputum samples using ddPCR if the sputum cytology was positive. Sputum samples should be collected in patients with CT tumor size ≥ 29 mm for EGFR mutation analysis.

scholarly journals Targeting HSPA1A in ARID2-deficient lung adenocarcinoma

2021 ◽  
Author(s):  
Xue Wang ◽  
Yuetong Wang ◽  
Zhaoyuan Fang ◽  
Hua Wang ◽  
Jian Zhang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Genetically Engineered ◽  
Malignant Progression ◽  
Murine Models ◽  
Rna Seq ◽  
Potential Therapeutic Target ◽  
Lung Cancers ◽  
Integrative Analyses

Abstract Somatic mutations of the chromatin remodeling gene ARID2 are observed in about 7% of human lung adenocarcinoma (LUAD). However, the role of ARID2 in the pathogenesis of LUAD remains largely unknown. Here we find that ARID2 expression is decreased during the malignant progression of both human and mice LUAD. Using two KrasG12D-based genetically engineered murine models (GEMM), we demonstrate that ARID2 knockout significantly promotes lung cancer malignant progression and shortens the overall survival. Consistently, ARID2 knockdown significantly promotes cell proliferation in human and mice lung cancer cells. Through integrative analyses of Chip-Seq and RNA-Seq data, we find that Hspa1a is up-regulated by Arid2 loss. Knockdown of Hspa1a specifically inhibits malignant progression of Arid2-deficient but not Arid2-wt lung cancers in both cell lines as well as animal models. Treatment with Hspa1a inhibitor could significantly inhibit the malignant progression of lung cancer with Arid2 deficiency. Together, our findings establish ARID2 as an important tumor suppressor in LUAD with novel mechanistic insights, and further identify HSPA1A as a potential therapeutic target in ARID2-deficient LUAD.

scholarly journals Requirement for PKC Epsilon in Kras-Driven Lung Tumorigenesis

2020 ◽  
Author(s):  
Rachana Garg ◽  
Mariana Cooke ◽  
Shaofei Wang ◽  
Fernando Benavides ◽  
Martin C. Abba ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Cancer Therapeutics ◽  
Rna Seq ◽  
Lung Tumorigenesis ◽  
Mechanistic Analysis ◽  
Oncogenic Driver ◽  
Histological Form

ABSTRACTNon-small cell lung cancer (NSCLC), the most frequent subtype of lung cancer, remains a highly lethal malignancy and one of the leading causes of cancer deaths worldwide. Mutant KRAS is the prevailing oncogenic driver of lung adenocarcinoma, the most common histological form of NSCLC. In this study, we examined the role of PKCε, an oncogenic kinase highly expressed in NSCLC and other cancers, in KRAS-driven tumorigenesis. Notably, database analysis revealed an association between PKCε expression and poor outcome in lung adenocarcinoma patients specifically having KRAS mutation. By generating a PKCε-deficient, conditionally activatable allele of oncogenic Kras (LSL-KrasG12D;PKCε−/− mice) we were able to demonstrate the requirement of PKCε for Kras-driven lung tumorigenesis in vivo, which is consistent with the impaired transformed growth observed in PKCε-deficient KRAS-dependent NSCLC cells. Moreover, PKCε-knockout mice were found to be less susceptible to lung tumorigenesis induced by benzo[a]pyrene, a carcinogen that induces mutations in Kras. Mechanistic analysis using RNA-Seq revealed little overlapping for PKCε and KRAS in the control of genes/biological pathways relevant in NSCLC, suggesting that a permissive role of PKCε in KRAS-driven lung tumorigenesis may involve non-redundant mechanisms. Our results thus highlight the relevance and potential of targeting PKCε for lung cancer therapeutics.

The Role of Docetaxel in Nonplatinum-Based Combination Chemotherapy for non—small-Cell Lung Cancer

2002 ◽  
Vol 3 ◽  
pp. S12-S16 ◽  
Author(s):  
W. Jeffrey Petty ◽  
Joerg Rathmann ◽  
Konstantin H. Dragnev ◽  
James R. Rigas
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Combination Chemotherapy ◽  
Small Cell ◽  
Small Cell Lung

Prognostic Role of TLE Family in Lung Adenocarcinoma

2020 ◽  
Author(s):  
Qianli Ma ◽  
Fei Xiao ◽  
Huajie Xing ◽  
Zhiyi Song ◽  
Jin Zhang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Lung Adenocarcinoma ◽  
Common Type ◽  
Cancer Death ◽  
Prognostic Role ◽  
Independent Risk Factors ◽  
Tcga Dataset ◽  
The Relationship ◽  
Enhancer Of Split

Abstract Background Lung cancer is the most commonly diagnosed cancer and the leading cause of cancer death worldwide. Lung adenocarcinoma (LUAD) is the most common type of lung cancer. Transducin-like Enhancer of split (TLE) family proteins repress transcription by multiple mechanisms. The prognostic role of TLEs in LUAD is still unclear. Methods We took TCGA dataset to analyze the relationship between the expression of TLEs and LUAD outcome. Results The expression of TLEs were different between 59 normal and 513 tumor samples. High TLE1 and low TLE2 were associated with poor PFS and OS (all p＜0.050). Multivariate analysis demonstrated that high TLE1 and low TLE2 were independent risk factors. Moreover, the combination of TLE1 and TLE2 was a better tool in prognostication. Conclusions High TLE1 and low TLE2 expressions are independent adverse prognostic factors and can be used as prognostic biomarkers in LUAD.

scholarly journals Diagnosis and outcome of resected solitary pulmonary nodules after liver transplantation

2019 ◽  
Author(s):  
Mari Tone ◽  
Nobuyasu Awano ◽  
Takehiro Izumo ◽  
Hanako Yoshimura ◽  
Tatsunori Jo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Liver Transplantation ◽  
Early Stage ◽  
Lung Resection ◽  
Invasive Pulmonary Aspergillosis ◽  
Primary Lung Cancer ◽  
Pulmonary Nodules ◽  
Solitary Pulmonary Nodules ◽  
Computed Tomography Scans

Abstract Objective Solitary pulmonary nodules after liver transplantation are challenging clinical problems. Herein, we report the causes and clinical courses of resected solitary pulmonary nodules in patients who underwent liver transplantation. Methods We retrospectively obtained medical records of 68 patients who underwent liver transplantation between March 2009 and June 2016. This study mainly focused on patients with solitary pulmonary nodules observed on computed tomography scans during follow-ups that were conducted until their deaths or February 2019. Results Computed tomography scans revealed solitary pulmonary nodules in 7 of the 68 patients. Definitive diagnoses were obtained using video-assisted lung resection in all seven patients. None experienced major postoperative complications. The final pathologic diagnoses were primary lung cancer in three patients, pulmonary metastases from hepatocellular carcinoma in one patient, invasive pulmonary aspergillosis in one patient, post-transplant lymphoproliferative disorder in one patient, and hemorrhagic infarction in one patient. The three patients with lung cancer were subsequently treated with standard curative resection. Conclusions Solitary pulmonary nodules present in several serious but potentially curable diseases, such as early-stage lung cancer. Patients who present with solitary pulmonary nodules after liver transplantation should be evaluated by standard diagnostic procedures, including surgical biopsy if necessary.

scholarly journals An elderly female patient with ROS1 rearrangement primary lung adenocarcinoma and breast carcinoma: a rare case report and review of the literature

2019 ◽  
Vol 2 (3) ◽  
pp. 197-203 ◽  
Author(s):  
Xiaojuan Yang ◽  
Diyuan Qin ◽  
Yu Zhang ◽  
Xue Li ◽  
Ning Liu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lung Cancer ◽  
Elderly Patients ◽  
Lung Adenocarcinoma ◽  
Female Patient ◽  
Malignant Tumors ◽  
Primary Lung Cancer ◽  
Lung Cancer Mortality ◽  
Anaplastic Lymphoma ◽  
Reduced Dose

Abstract We report the case of a 90-year-old female patient who was suffering from c-ros oncogene 1 (ros-1) rearrangement adenocarcinoma and breast cancer. After about 14 months of a reduced dose of crizotinib treatment, she had a stable disease according to the Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST 1.1). This patient’s case demonstrates that ros-1 rearrangements are not limited to patients of young age. In addition, this case indicates that crizotinib, as second-line, or even first-line, treatment may be effective and manageable in elderly patients. Furthermore, for elderly patients carrying a ros1 fusion, a reduced dose of crizotinib may be efficacious rather than a resistance factor. Based on our findings, we recommend that elderly patients with advanced lung adenocarcinoma should be considered for inclusion in molecular screening for ros-1 translocation, especially for never-smokers negative for epidermal growth factor receptor (egfr) mutation and the fusion between echinoderm microtubule associated protein-like 4 (EML4) and anaplastic lymphoma kinase (ALK). This deserves attention because the population is aging, with increasing incidence and morbidity of multiple primary malignant tumors. Neglect of breast nodules at the onset is one of the limitations of our case, as combination of primary lung cancer with breast cancer is common. Above all, use of antiestrogens before and after the diagnosis of non-small-cell lung cancer is related to a reduced risk of lung cancer mortality. Therefore, careful attention should always be paid to these cases.

Sign in / Sign up

Export Citation Format

Share Document