We describe an unique case of co-presentation of ADC and SCC in two different disease sites, both harbouring ALK rearrangement. A 57-year-old male never smoker presented with a left adrenal mass. CT Scan showed a right superior lobe mass, bilateral pulmonary nodules (Fig. 1 A), and bone metastases. The lung biopsy documented ADC with moderate differentiation and ALK rearrangement by fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC). The patient was treated with Crizotinib but, after 4 months, the CT showed a near complete response of the pulmonary disease (Fig. 1 B), while a progression of the left adrenal metastasis was observed. (Fig. 2 A, Fig. 2B). A left adrenal biopsy showed a SCC histology, with ALK rearrangement confirmed both by IHC and FISH. The treatment was switched to alectinib without respoinse so the patient received chemotherapy. The absence of an initial biopsy of the adrenal mass doesn't allow to distinguish between a lung ADC to SCC transdiffere..... READ ARTICLE
Journal of Thoracic Oncology DOI:10.1016/j.jtho.2019.08.2028
Authors: V. Longo, A. Catino, D. Galetta, G. Del Bene, R. Lacalamita, M. Montrone, F. Pesola, D. Petriella, P. Pizzutilo, S. Tommasi