Atypical response to erlotinib in a patient with metastatic lung adenocarcinoma: a case report

Journal of Medical Case Reports

Denis Moro-Sibilot²  Gilbert Ferretti¹  Augustin Pirvu³  Léonie Ferrer²  Elodie Meynet²  Linda Sakhri² 

[1] Service de radiologie, CHU Grenoble, 38043 Grenoble cedex 9, France;Pôle thorax et vaisseaux, Unité d’oncologie thoracique, CHU Grenoble, BP217, 38043 Grenoble cedex 9, France;Service de chirurgie thoracique, vasculaire et endocrinienne, CHU Grenoble, BP217, 38043 Grenoble cedex 9, France

关键词: Tyrosine kinase inhibitors;    Pulmonary cysts;    Pulmonary adenocarcinoma;    Erlotinib;    EGFR mutation;    Bilateral pneumothorax;   

Others  :  1181017
DOI  :  10.1186/1752-1947-8-335

 received in 2014-05-04, accepted in 2014-08-08,  发布年份 2014

【 摘 要 】

Introduction

Tyrosine kinase inhibitors are widely prescribed in thoracic oncology and have excellent responses as a first-line treatment for locally advanced or metastatic lung cancer with epidermal growth factor receptor mutations. The side effects of tyrosine kinase inhibitors are mostly gastrointestinal and dermatological, and are usually resolved after symptomatic treatment. However, new complications have now arisen due to increased use of these drugs. Here we report a side effect of erlotinib that has not been described previously: that is, metastatic lung tumor nodules were transformed into cysts, which ruptured the pleura and were responsible for bilateral life-threatening pneumothorax.

Case presentation

We report the case of a 35-year-old Caucasian woman with metastatic adenocarcinoma and a deletion in epidermal growth factor receptor exon 19 (del E746-A750). She was treated with erlotinib for metastatic lung adenocarcinoma.

Treatment with erlotinib resulted in the replacement of pulmonary tumor nodules with air-containing cysts. These cysts ruptured in the pleura causing a life-threatening bilateral pneumothorax.

To the best of our knowledge, this tumor–cystic response after erlotinib therapy has not been previously described.

Conclusions

Tyrosine kinase inhibitors are widely prescribed in thoracic oncology, and managing toxicities must be optimal in order to improve adherence. Transformation of pulmonary nodules into cysts must be known and clinicians should be aware of this potential complication, which can lead to life-threatening pneumothorax.

【 授权许可】

   
2014 Sakhri et al.; licensee BioMed Central Ltd.

【 图 表 】

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