Abstract YO37
Case summary
57-year-old man presented with chronic progressive headache for 3 months. He initially visited hospital due to chronic headache with projectile vomiting and ataxia. He also had anorexia and lost 7 kg but he had no respiratory tract symptoms including chronic cough, dyspnea, and chest pain. His smoking history was about 10 pack-year. On his physical examination, pupils with 4 mm. in size and reactive to light, papilledema both eyes and tongue deviation to the left side were detected but others were unremarkable. His routine investigations including chest radiography were unremarkable. He was evaluated with MRI of the brain which showed multiple enhancing lesions at the left lateral ventricle, left temporal horn, 4th ventricle, bilateral foramen of Luschka and both sides of foramen magnum with obstructive hydrocephalus. Consequently, he was diagnosed of intraventricular papilloma and underwent craniotomy with tumor removal and ventriculoperitoneal shunt. Subsequently, he received whole brain radiation therapy for 200 cGy. The pathological result from his intraventricular mass demonstrated papillary tumor with hobnail appearance and further immunohistochemistry was processed. The final result showed strongly diffuse positive AE1/AE3, EMA, CK7, TTF-1, and NapsinA while negative CK20 and Thyroglobulin. Consequently, it was compatible with metastatic adenocarcinoma, most likely from primary lung carcinoma. Further molecular testing demonstrated EGFR Exon 19 deletion mutation by PCR but no detection of ALK rearrangement. Later, he was evaluated with CT of the chest and upper abdomen which showed a 2.4x1.3 cm spiculated pulmonary mass at the apicoposterior segment of the left upper lobe and 0.8 cm pathological lymph node at AP window region. Bone metastasis at T3 vertebral bodies was also seen. Finally, he was diagnosed as adenocarcinoma of the left lung with intraventricular metastasis; stage T1cN2M1b. After completion of WBRT, his neurologic symptoms were improved and he still had no respiratory tract symptoms. His ECOG performance status was 1. Discussing treatment options, the patient and his family made a decision to enroll in the clinical trial for new EGFR TKI.
Clinical trial identification
Editorial acknowledgement
Resources from the same session
133P - Prognostic and predictive factors from the phase III CELESTIAL trial of cabozantinib (C) versus placebo (P) in previously treated advanced hepatocellular carcinoma (aHCC)
Presenter: Thomas Yau
Session: Poster display session
Resources:
Abstract
134P - Identification, development and validation of a circulating miRNA-based diagnostic signature for early detection of gastric cancer
Presenter: Daisuke Izumi
Session: Poster display session
Resources:
Abstract
135P - The promising key genes associated with tumour microenvironment and prognosis of hepatocellular carcinoma
Presenter: Jing Fang
Session: Poster display session
Resources:
Abstract
136P - Helicobacter pylori-positive gastric diffuse large B-cell lymphoma: A subset with distinct prognostic features
Presenter: Yuan Cheng
Session: Poster display session
Resources:
Abstract
137P - Significant benefit of pyrotinib combined with SHR6390 in patients with multiline-resistant HER2-positive advanced gastric cancer
Presenter: Zuhua Chen
Session: Poster display session
Resources:
Abstract
138P - Incidence of supracarinal lymph node positivity in operated cases of total esophagectomy: Short term results from a tertiary cancer centre
Presenter: Akhil Palod
Session: Poster display session
Resources:
Abstract
139P - Prognostic usefulness of advanced lung cancer inflammation index in locally-advanced pancreatic carcinoma patients treated with radical chemoradiotherapy
Presenter: Ayberk Besen
Session: Poster display session
Resources:
Abstract
140P - Pancreaticoduodenectomy versus combined neoadjuvant chemotherapy and pancreaticoduodenectomy: Survival patterns among patients with stage II & III periampullary carcinoma
Presenter: Mai Abdelkader
Session: Poster display session
Resources:
Abstract
141P - A 13-gene signature of DNA repair predicts prognosis in gastric cancer patients
Presenter: Jinjia Chang
Session: Poster display session
Resources:
Abstract
142P - Relation between Interleukin -4 (590C/T) gene polymorphism and hepatocellular carcinoma risk in HBV and HCV patients
Presenter: Suzy Gohar
Session: Poster display session
Resources:
Abstract