Kanaji N, Bandoh S, Hayashi T, Haba R, Watanabe N, Ishii T, Kunitomo A, Takahama T, Tadokoro A, Imataki O, Dobashi H, Matsunaga T. EGFR mutation identifies distant squamous cell carcinoma as metastasis from lung adenocarcinoma. World J Respirol 2013; 3(2): 38-43 [DOI: 10.5320/wjr.v3.i2.38]
Corresponding Author of This Article
Nobuhiro Kanaji, MD, PhD, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kanaji@med.kagawa-u.ac.jp
Research Domain of This Article
Respiratory System
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Nobuhiro Kanaji, Shuji Bandoh, Naoki Watanabe, Tomoya Ishii, Asako Kunitomo, Takayuki Takahama, Akira Tadokoro, Osamu Imataki, Hiroaki Dobashi, Takuya Matsunaga, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Toshitetsu Hayashi, Reiji Haba, Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Author contributions: Kanaji N acquired the patient data, searched the literature, and drafted the manuscript; Bandoh S, Imataki O, Dobashi H, and Matsunaga T made revisions to the manuscript; Watanabe N, Ishii T, Kunitomo A, Takahama T, and Tadokoro A performed the bronchoscopic examination; Hayashi T and Haba R performed the histopathological evaluation of the specimens.
Correspondence to: Nobuhiro Kanaji, MD, PhD, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kanaji@med.kagawa-u.ac.jp
Telephone: +81-87-8912145 Fax: +81-87-8912147
Received: March 18, 2013 Revised: May 7, 2013 Accepted: June 1, 2013 Published online: July 28, 2013 Processing time: 121 Days and 23.3 Hours
Abstract
Lung cancer metastasis is typically determined by histologic similarity between distant and primary lesions. Herein, we present a 70-year-old Japanese woman with an adenocarcinoma in her lung and a squamous cell carcinoma in her femur; both tumors had an identical epidermal growth factor receptor mutation, G719S. This indicated that both tumors had a common origin, despite their histologic dissimilarity. The tumor in the femur was thus identified genetically as a lung cancer metastasis. This case suggests that genetic analysis can determine whether a distant lesion is a lung cancer metastasis, particularly when the histology differs from that of the primary lesion.
Core tip: A tumor in the femur was identified genetically as a lung cancer metastasis. This case suggests that a matching epidermal growth factor receptor (EGFR) mutation in a distant lesion can validate a diagnosis of lung cancer metastasis, even if it differs histologically from the primary lesion. To the best of our knowledge, this is the first report showing the use of EGFR genetic analysis to identify a distant lesion as a lung cancer metastasis. In the era of molecularly-targeted treatments for non-small cell lung cancer, combined pathological diagnosis and genetic analysis could lead to more precise diagnoses and better understanding of histogenesis and more appropriate therapeutic selections.
