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Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry

Cancer of unknown primary (CUP) accounts for 5% of all malignancies. Patients with CUP may live averagely for 8 months after diagnosis, and thus, rapid and reasonable diagnosis is necessary. Among patients with CUP, anaplastic lymphoma kinase (ALK)-overexpressing CUPs, whose primary sites were confi...

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Autores principales: Kato, Yoriko, Shimazu, Kazuhiro, Fukuda, Koji, Yoshida, Taichi, Taguchi, Daiki, Shinozaki, Hanae, Nanjyo, Hiroshi, Shibata, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832189/
https://www.ncbi.nlm.nih.gov/pubmed/35221965
http://dx.doi.org/10.1159/000521157
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author Kato, Yoriko
Shimazu, Kazuhiro
Fukuda, Koji
Yoshida, Taichi
Taguchi, Daiki
Shinozaki, Hanae
Nanjyo, Hiroshi
Shibata, Hiroyuki
author_facet Kato, Yoriko
Shimazu, Kazuhiro
Fukuda, Koji
Yoshida, Taichi
Taguchi, Daiki
Shinozaki, Hanae
Nanjyo, Hiroshi
Shibata, Hiroyuki
author_sort Kato, Yoriko
collection PubMed
description Cancer of unknown primary (CUP) accounts for 5% of all malignancies. Patients with CUP may live averagely for 8 months after diagnosis, and thus, rapid and reasonable diagnosis is necessary. Among patients with CUP, anaplastic lymphoma kinase (ALK)-overexpressing CUPs, whose primary sites were confirmed to be the lungs (Lung-CUP) by using antibodies against cytokeratin 7, thyroid transcription factor-1, and Napsin A, along with clinical characteristics progressed rapidly and were very sensitive to the ALK inhibitor alectinib. The incidence of ALK alteration in Lung-CUP is 19%. Consequently, it is advised that Lung-CUP be examined by immunohistochemistry (IHC) with an anti-ALK antibody. Alternative examinations, such as a cancer genome test, require as much as 2 months to complete, whereas IHC can be completed within days. In this report, a rapid assessment by IHC led to alectinib treatment, which resulted in good outcomes in 2 cases of Lung-CUP. Alectinib was effective for ALK-altered Lung-CUPs.
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spelling pubmed-88321892022-02-25 Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry Kato, Yoriko Shimazu, Kazuhiro Fukuda, Koji Yoshida, Taichi Taguchi, Daiki Shinozaki, Hanae Nanjyo, Hiroshi Shibata, Hiroyuki Case Rep Oncol Case Report Cancer of unknown primary (CUP) accounts for 5% of all malignancies. Patients with CUP may live averagely for 8 months after diagnosis, and thus, rapid and reasonable diagnosis is necessary. Among patients with CUP, anaplastic lymphoma kinase (ALK)-overexpressing CUPs, whose primary sites were confirmed to be the lungs (Lung-CUP) by using antibodies against cytokeratin 7, thyroid transcription factor-1, and Napsin A, along with clinical characteristics progressed rapidly and were very sensitive to the ALK inhibitor alectinib. The incidence of ALK alteration in Lung-CUP is 19%. Consequently, it is advised that Lung-CUP be examined by immunohistochemistry (IHC) with an anti-ALK antibody. Alternative examinations, such as a cancer genome test, require as much as 2 months to complete, whereas IHC can be completed within days. In this report, a rapid assessment by IHC led to alectinib treatment, which resulted in good outcomes in 2 cases of Lung-CUP. Alectinib was effective for ALK-altered Lung-CUPs. S. Karger AG 2022-01-17 /pmc/articles/PMC8832189/ /pubmed/35221965 http://dx.doi.org/10.1159/000521157 Text en Copyright © 2022 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case Report
Kato, Yoriko
Shimazu, Kazuhiro
Fukuda, Koji
Yoshida, Taichi
Taguchi, Daiki
Shinozaki, Hanae
Nanjyo, Hiroshi
Shibata, Hiroyuki
Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry
title Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry
title_full Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry
title_fullStr Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry
title_full_unstemmed Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry
title_short Two Cases of ALK-Altered Cancers of Unknown Primary Diagnosed by Immunohistochemistry
title_sort two cases of alk-altered cancers of unknown primary diagnosed by immunohistochemistry
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8832189/
https://www.ncbi.nlm.nih.gov/pubmed/35221965
http://dx.doi.org/10.1159/000521157
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