Frontiers in Oncology (Jun 2021)

Case Report: EGFR-Positive Early-Stage Lung Adenocarcinoma Transforming to Squamous Cell Carcinoma After TKI Treatment

  • Jiatao Liao,
  • Jiatao Liao,
  • Yuan Li,
  • Yuan Li,
  • Chang Liu,
  • Chang Liu,
  • Qianqian Long,
  • Qianqian Long,
  • Jialei Wang,
  • Jialei Wang

DOI
https://doi.org/10.3389/fonc.2021.696881
Journal volume & issue
Vol. 11

Abstract

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The histological transformation from epidermal growth factor receptor (EGFR)-mutated adenocarcinoma (ADC) to squamous cell carcinoma (SCC) after tyrosine kinase inhibitor (TKI) treatment is rare. We present a case of a patient who transitioned from early-stage primary lung ADC with partial squamous differentiation, EGFR mutation and amplification, to adrenal gland metastasis as SCC with EGFR amplification disappearance 115-months after surgery, during which gefitinib and local radiotherapy were utilized for the metastasis in the right femoral head and mediastinal lymph nodes. This case might indicate a possible mechanism of EGFR inhibition resistance with SCC transition and EGFR amplification loss from the initially well-responding ADC, especially those with SCC or partial squamous differentiation. The optimal post-progression therapy for ADC-SCC patients is challenging and further studies are needed.

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