An ALK-positive lung adenocarcinoma with gastric and skin metastasis: a case report and literature review

Primary lung cancer with gastric metastasis is rare to see in the world, little known about its characteristics. Here, we describe first case of primary adenocarcinoma and skin metastases along a review literature help clinical decision making. A 49-year-old woman admitted our department for abdominal distension. The immunohistochemistry staining biopsy fundus, back showed positive CK5/6, TTF-1, Napsin CK7, but negative CK20, which strongly indicated all them were homologous might originate from adenocarcinoma. Chromosome mutation analysis presented an EML4-ALK fusion gene. Brain occurred after 6 months crizotinib treatment. More than two later, intracranial lesions became more larger as she persisted taking plus whole-brain radiotherapy (WBRT). Hence, alectinib was performed due continuous growth brain lesions. When reexamined three craniocerebral significantly reduced tumor markers up normal level. This comprised 42 published reports total. Generally, average morbidity age 62 years old, male smoking history prone it. It could be found that squamous cell carcinoma (17/38) accounts high proportion gastrointestinal pathology, most poorly differentiated. Surgical excision supposed improve long-term prognosis, mitigate associated complications, decrease patients' pain, enhance quality life. Gastric apt metastasize brain, prognosis inferior. Crizotinib preventive WBRT may optimal choice NSCLC patients harboring ALK initial treatment metastasis. However, If lesion keep on going, timely replacement appropriate choice.