Cargando…

A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review

Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of non–small cell lung cancer (NSCLC), accounting for about 0.6% of all primary lung adenocarcinoma. Although epidermal growth factor receptor (EGFR) mutation is common in primary lung adenocarcinoma, it is rarely reported in PEAC. This case...

Descripción completa

Detalles Bibliográficos
Autores principales: Xu, Xiaohu, Chen, Dong, Wu, Xiao, Wang, Qi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538506/
https://www.ncbi.nlm.nih.gov/pubmed/36212391
http://dx.doi.org/10.3389/fonc.2022.988625
_version_ 1784803359319916544
author Xu, Xiaohu
Chen, Dong
Wu, Xiao
Wang, Qi
author_facet Xu, Xiaohu
Chen, Dong
Wu, Xiao
Wang, Qi
author_sort Xu, Xiaohu
collection PubMed
description Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of non–small cell lung cancer (NSCLC), accounting for about 0.6% of all primary lung adenocarcinoma. Although epidermal growth factor receptor (EGFR) mutation is common in primary lung adenocarcinoma, it is rarely reported in PEAC. This case report describes a PEAC patient with co-mutations of EGFR, Kirsten rat sarcoma viral oncogene (KRAS), and TP53, being treated with immunotherapy combined with chemotherapy. A 69-year-old man complained of cough and expectoration with bloody sputum for 2 weeks. The lung-enhanced CT scan showed a massive soft tissue shadow, about 46 × 35 mm in the lower lobe of the right lung. The neoplasm sample in the lower lobe of the right lung was obtained using CT-guided fine-needle aspiration (FNA). Immunohistochemical assays showed that the tumor was positive for CK7, CDX-2, C-MET, and villin. Gastroscopy and rectal colonoscopy had been performed respectively to exclude a diagnosis of colorectal adenocarcinoma. The patient was finally diagnosed with pulmonary intestinal adenocarcinoma. Next-generation sequencing (NGS) analysis showed a rare EGFR exon 19 missense mutation (c.2257C>T, p.P753S), KRAS exon 2 missense mutation (c.35G>T, p.G12V), and TP53 exon 5 missense mutation (c.401T>C, p.F134S). The lung-enhanced CT scan showed that the tumor shrank after four cycles of chemotherapy combined with immunotherapy. We hope that this case report can increase the understanding of this rare type of tumor and provide new molecular indications for diagnosis and individualized treatment. Furthermore, the combination of chemotherapy and immunotherapy seems to be an effective therapy for PEAC. Whether the use of immunotherapy can provide clinical benefits needs to be further explored with more samples in future studies.
format Online
Article
Text
id pubmed-9538506
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-95385062022-10-08 A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review Xu, Xiaohu Chen, Dong Wu, Xiao Wang, Qi Front Oncol Oncology Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of non–small cell lung cancer (NSCLC), accounting for about 0.6% of all primary lung adenocarcinoma. Although epidermal growth factor receptor (EGFR) mutation is common in primary lung adenocarcinoma, it is rarely reported in PEAC. This case report describes a PEAC patient with co-mutations of EGFR, Kirsten rat sarcoma viral oncogene (KRAS), and TP53, being treated with immunotherapy combined with chemotherapy. A 69-year-old man complained of cough and expectoration with bloody sputum for 2 weeks. The lung-enhanced CT scan showed a massive soft tissue shadow, about 46 × 35 mm in the lower lobe of the right lung. The neoplasm sample in the lower lobe of the right lung was obtained using CT-guided fine-needle aspiration (FNA). Immunohistochemical assays showed that the tumor was positive for CK7, CDX-2, C-MET, and villin. Gastroscopy and rectal colonoscopy had been performed respectively to exclude a diagnosis of colorectal adenocarcinoma. The patient was finally diagnosed with pulmonary intestinal adenocarcinoma. Next-generation sequencing (NGS) analysis showed a rare EGFR exon 19 missense mutation (c.2257C>T, p.P753S), KRAS exon 2 missense mutation (c.35G>T, p.G12V), and TP53 exon 5 missense mutation (c.401T>C, p.F134S). The lung-enhanced CT scan showed that the tumor shrank after four cycles of chemotherapy combined with immunotherapy. We hope that this case report can increase the understanding of this rare type of tumor and provide new molecular indications for diagnosis and individualized treatment. Furthermore, the combination of chemotherapy and immunotherapy seems to be an effective therapy for PEAC. Whether the use of immunotherapy can provide clinical benefits needs to be further explored with more samples in future studies. Frontiers Media S.A. 2022-09-23 /pmc/articles/PMC9538506/ /pubmed/36212391 http://dx.doi.org/10.3389/fonc.2022.988625 Text en Copyright © 2022 Xu, Chen, Wu and Wang https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Xu, Xiaohu
Chen, Dong
Wu, Xiao
Wang, Qi
A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review
title A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review
title_full A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review
title_fullStr A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review
title_full_unstemmed A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review
title_short A pulmonary enteric adenocarcinoma patient harboring a rare EGFR exon 19 P753S mutation: Case report and review
title_sort pulmonary enteric adenocarcinoma patient harboring a rare egfr exon 19 p753s mutation: case report and review
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538506/
https://www.ncbi.nlm.nih.gov/pubmed/36212391
http://dx.doi.org/10.3389/fonc.2022.988625
work_keys_str_mv AT xuxiaohu apulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT chendong apulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT wuxiao apulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT wangqi apulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT xuxiaohu pulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT chendong pulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT wuxiao pulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview
AT wangqi pulmonaryentericadenocarcinomapatientharboringarareegfrexon19p753smutationcasereportandreview