Journal of Yeungnam Medical Science

Case Reports

Efficacy of epidermal growth factor receptor-tyrosine kinase inhibitors for patient with leptomeningeal metastasis of epidermal growth factor receptor mutant non-small cell lung cancer.: Jong Sik Lee, Kyung Ann Lee, Kang Hoon Lee, Sun Young Moon, In Ae Kim, Sung Jin Jeon, Jae Ki Min, Hee Joung Kim, Kye Young Lee; Yeungnam Univ J Med. 2016;33(1):64-67. Published online June 30, 2016; DOI: https://doi.org/10.12701/yujm.2016.33.1.64

Abstract PDF: We report on a 64-year-old man with leptomeningeal metastasis (LM) from an epidermal growth factor receptor (EGFR)-mutated adenocarcinoma of the lung. He was treated with paclitaxel, cisplatin. After completion of chemotherapy, he complained of headache, nausea, and vomiting. EGFR-mutated tumor cells were identified from the cerebrospinal fluid (CSF). Second-line therapy with gefitinib, methotrexate was started. After receiving gefitinib for 4 weeks, he had no more headaches or vomiting. Eleven months after initiation of gefitinib, he developed headache and nausea. Chest computed tomography showed aggravation of bone metastasis. Third-line therapy was started with gemcitabine and carboplatin. Two weeks later, he experienced disorientation. After a fourth relapse within the central nervous system, the therapy was switched to erlotinib and significant improvement of LM was achieved. This case shows that LM can be diagnosed by detecting EGFR mutation in CSF and EGFR tyrosine kinase inhibitors are effective for LM from EGFR mutant non-small cell lung cancer.

A Case of Gefitinib (Iressa(R))-associated Tumor Lysis Syndrome in Adenocarcinoma of the Lung.: Kyu Jin Kim, Won Jong Park, Sung Ken Yu, Kyeong Cheol Shin, Jin Hong Chung, Myung Soo Hyun, Kwan Ho Lee; Yeungnam Univ J Med. 2006;23(2):221-226. Published online December 31, 2006; DOI: https://doi.org/10.12701/yujm.2006.23.2.221

Abstract PDF: The tumor lysis syndrome has been described as biochemical disturbances associated with rapid destruction of tumor cells and subsequent synchronized massive release of cellular breakdown products sufficient to overwhelm excretory mechanisms and the body's normal reutilization capacity. The cardinal signs of the tumor lysis syndrome are hyperkalemia, hyperphosphatemia, hypocalcemia and hyperuricemia. Gefitinib (Iressa) is an oral, selective epidermal growth factor receptor (EGFR) inhibitor that has activity in female, non-smoker and non-small cell lung cancer with an EGFR mutation. Gefitinib is a well tolerated drug with few side effects. It has been associated with skin rash, diarrhea, nausea, a decrease in liver function and interstitial lung disease. However, there is no prior report of the tumor lysis syndrome associated with gefitinib. We report a case of a 54 year-old woman who developed tumor lysis syndrome that might have been induced by gefitinib after the treatment of adenocarcinoma of lung with an EGFR mutation.

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