ALK阳性肺腺癌卵巢转移1例报道

Ovarian metastasis from ALK-positive lung adenocarcinoma:One case report

目的 :探讨间变性淋巴瘤激酶(anaplastic lymphoma kinase,ALK)阳性的非小细胞肺癌(non-small cell lung cancer,NSCLC)卵巢转移患者的临床特征、诊断及治疗。方法 :对北京医院收治的1例ALK阳性非小细胞肺癌伴卵巢转移患者的病例资料进行复习,并随访至2015年1月。结果 :本例女性患者48岁,初诊为右肺腺癌(Ⅳ期),单发脑转移。右肺中叶切除术后,荧光原位杂交法检测组织标本为ALK阳性。服用克唑替尼治疗2年后,发现单侧卵巢囊性肿块;手术切除后,病理检查显示为肺腺癌转移,且Ventana免疫组织化学法检测转移灶组织标本为ALK阳性。手术后患者继续服用克唑替尼治疗,至随访结束未出现疾病进展。结论 :ALK阳性的女性NSCLC患者在随访期间应关注卵巢病变,克唑替尼治疗可能使这类患者获益。

Objective：To evaluate the clinical features,diagnosis and treatment of anaplastic lymphoma kinase（ALK）-positive non-small cell lung cancer（NSCLC） patient with ovarian metastasis.Methods：The clinical record of one case of ALK-positive NSCLC with ovarian metastasis from Beijing Hospital was reviewed.The follow-up deadline was January 201 5.Results：This 48-year old female patient was diagnosed of stage IV right lung adenocarcinoma,with single brain metastasis.After receiving right middle lobectomy,the positive expression of ALK in tumor tissue was detected by fluorescence in situ hybridization（FISH）.After the patient received crizotinib treatment for 2 years,a cystic mass in left ovary was observed.The patient underwent a ovarian cystectomy.The immunohistochemistry examination of tissue specimen supported a lung metastasis.Ventana immunohistochemistry detection showed the positive expression of ALK in ovarian metastasis lesion.The patient continued on crizotinib treatment after surgery whithout progression till the last follow-up.Conclusion：Physicians should be aware of the possibility for ovary metastasis during follow-up in female patients with ALK-positive NSCLC.Crizotinib may bring clinical benefit for these patients.