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
154P - Genetic characteristics of participants in the Australian Pancreatic Screening Study
Presenter: Krithika Murali
Session: Poster display session
Resources:
Abstract
155P - Mean Platelet Volume (MPV) is it a new prognostic marker in resectable carcinoma stomach?
Presenter: Girish M. S
Session: Poster display session
Resources:
Abstract
156P - A positive feedback between IDO1 metabolite and COL12A1 via MAPK pathway to promote gastric cancer metastasis
Presenter: Zhen Xiang
Session: Poster display session
Resources:
Abstract
157P - Lymph node ratio (LNR) a better prognostic factor after D2 gastrectomy
Presenter: Jitin Yadav
Session: Poster display session
Resources:
Abstract
158P - A clinical significance of preoperative C-reactive protein/albumin ratio in patients with extrahepatic bile duct cancer
Presenter: Kim Jinkook
Session: Poster display session
Resources:
Abstract
159P - The relation between obesity and cancer of gastrointestinal tract in Korea: The data from Statistic Korea between 2001 and 2016
Presenter: Hee Man Kim
Session: Poster display session
Resources:
Abstract
160P - Clinical outcomes of second-line chemotherapy after progression on nab-paclitaxel plus gemcitabine in patients with metastatic pancreatic adenocarcinoma
Presenter: Jooyoung Ha
Session: Poster display session
Resources:
Abstract
161P - Chitinase 3-Like 1 gene (T/C) polymorphism and serum YKL-40 in hepatocellular carcinoma
Presenter: Alshimaa Alhanafy
Session: Poster display session
Resources:
Abstract
162P - Hypofractionated radiotherapy for pulmonary metastases from hepatocellular carcinoma: Treatment response and prognostic factors affecting survival
Presenter: In Young Jo
Session: Poster display session
Resources:
Abstract
163P - Excision repair cross-complementation group 1 and 2 (ERCC1/2) Single nucleotide polymorphisms and chemotherapy treatment outcome in Cholangiocarcinoma
Presenter: Thanachai Sanlung
Session: Poster display session
Resources:
Abstract