A case of lung adenocarcinoma with mandibular metastasis successfully controlled with alectinib

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  • NISHIMURA Masahiro
    Department of Dentistry and Oral Surgery, Ina Central Hospital
  • KOIKE Takeshi
    Department of Dentistry and Oral Surgery, Ina Central Hospital
  • YAJIMA Jun-ichi
    Department of Dentistry and Oral Surgery, North Alps Medical Center Azumi Hospital
  • KUNESHITA Norika
    Department of Dentistry and Oral Surgery, Ina Central Hospital
  • YAMADA Shin-ichi
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine
  • KURITA Hiroshi
    Department of Dentistry and Oral Surgery, Shinshu University School of Medicine

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  • アレクチニブ投与によりコントロールされた肺腺癌下顎骨転移の1例
  • アレクチニブ トウヨ ニ ヨリ コントロール サレタ ハイ センガン カガク コツ テンイ ノ 1レイ

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<p>Metastatic malignancies transferring to the oral and maxillofacial region from other organs account for about 1% of oral malignancies, and the prognosis is poor. Herein we report a case of lung adenocarcinoma discovered as a first indication of mandibular metastasis, which has been successfully controlled with alectinib, an Anaplastic Lymphoma Kinase (ALK) inhibitor. The patient was a 68-year-old women who visited our hospital complaining of swelling of the left mandibular gingiva and tooth mobility. Contrast-enhanced CT showed an ill-defined bone destruction in the left lower molar region of the mandible, and a biopsy was performed on the suspicion of a malignant tumor on the left mandible. The histopathological diagnosis was adenocarcinoma. An FDG-PET / CT examination showed accumulation of FDG in the S10 region of the right lung, and a medical oncologist clinically diagnosed mandibular metastasis of lung adenocarcinoma. Since immunohistochemical examination revealed positive for the ALK fusion gene and PD-L1 protein, the ALK inhibitor alectinib was administrated. At six months after the start of administration, the lesions of the primary and mandibular metastases disappeared from the image, and as of 3 years and 6 months after the start of administration, alectinib has been continued without major adverse events.</p>

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