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日本呼吸器学会英文誌 Respiratory Investigation
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Abstract

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Article in Japanese

Case Report

A case in which bone marrow biopsy from the site of metastasis led to identification of the EGFR T790M mutation

Yoshitaka Teia  Naoto Mikamia  Hiroko Aikob  Masaki Yamamotoa  Makoto Kudoa  Takeshi Kanekoc 

aRespiratory Disease Center Internal Medicine, Yokohama City University Medical Center
bRespiratory Medicine, Yokohama Rosai Hospital
cDepartment of Pulmonology, Yokohama City University Graduate School of Medicine

ABSTRACT

A 70-year-old man had been diagnosed with lung adenocarcinoma cT4N2M1b (multiple bone metastases) with EGFR mutation (exon19 deletion) and received first-line chemotherapy with gefitinib. However, although the primary cancer has been controlled, bone metastasis progressively worsened after one year's chemotherapy. To detect the EGFR T790M mutation which would suggest EGFR-TKI resistance, we performed a bone marrow biopsy from the iliac metastasis site and confirmed the mutation. He was then able to take osimertinib as second-line chemotherapy.
In the present report, we show that a biopsy from the metastasis site in the bone marrow should be considered so as to detect histological findings that may include driver gene mutation.

KEYWORDS

EGFR-mutant adenocarcinoma  Rebiopsy  Bone metastasis  Marrow biopsy 

Received 30 Oct 2018 / Accepted 25 Feb 2019

AJRS, 8(3): 163-166, 2019

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