A Case of ALK-Rearranged Combined Lung Adenocarcinoma and Neuroendocrine Carcinoma with Diffuse Bone Metastasis and Partial Response to Alectinib

Curr Oncol. 2022 Feb 3;29(2):848-852. doi: 10.3390/curroncol29020072.

Abstract

We report a rare case of stage IV pulmonary combined large-cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma (ACA), both demonstrating anaplastic lymphoma kinase (ALK) rearrangement by IHC and FISH. This 61-year-old lifelong nonsmoking Asian woman presented with a cough, and after diagnosis and surgical treatment, completed four cycles of adjuvant cisplatin and etoposide chemotherapy. She subsequently developed recurrence with bony metastases of exclusively ALK-positive LCNEC. Alectinib was started, and the patient experienced a partial response.

Keywords: ALK; LCNEC; adenocarcinoma; driver mutation; neuroendocrine.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma of Lung* / drug therapy
  • Adenocarcinoma of Lung* / genetics
  • Adenocarcinoma of Lung* / pathology
  • Anaplastic Lymphoma Kinase
  • Carbazoles
  • Carcinoma, Neuroendocrine* / drug therapy
  • Carcinoma, Neuroendocrine* / genetics
  • Carcinoma, Neuroendocrine* / pathology
  • Female
  • Humans
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Piperidines
  • Protein Kinase Inhibitors / therapeutic use

Substances

  • Carbazoles
  • Piperidines
  • Protein Kinase Inhibitors
  • Anaplastic Lymphoma Kinase
  • alectinib