ROS1‑rearranged high‑PD‑L1‑expressing lung adenocarcinoma manifesting as mediastinal tumor: A case report

Ogawa,Hiroyuki; Tanaka,Yugo; Tachihara,Motoko; Uehara,Keiichiro; Shimizu,Nahoko; Doi,Takefumi; Hokka,Daisuke; Maniwa,Yoshimasa

doi:10.3892/ol.2018.9622

January-2019 Volume 17 Issue 1

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January-2019 Volume 17 Issue 1

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Case Report

ROS1‑rearranged high‑PD‑L1‑expressing lung adenocarcinoma manifesting as mediastinal tumor: A case report

Authors:
- Hiroyuki Ogawa
- Yugo Tanaka
- Motoko Tachihara
- Keiichiro Uehara
- Nahoko Shimizu
- Takefumi Doi
- Daisuke Hokka
- Yoshimasa Maniwa
View Affiliations / Copyright

Affiliations: Division of Thoracic Surgery, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650‑0017, Japan, Department of Respiratory Medicine, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650‑0017, Japan, Department of Diagnostic Pathology, Graduate School of Medicine, Kobe University, Kobe, Hyogo 650‑0017, Japan
Pages: 488-491
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Published online on: October 25, 2018

https://doi.org/10.3892/ol.2018.9622
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Abstract

ROS proto‑oncogene 1 receptor tyrosine kinase (ROS1)‑rearranged lung cancer is rare and comprises only 1% of lung adenocarcinoma cases. It has recently been reported to have good response to crizotinib, a tyrosine kinase inhibitor of anaplastic lymphoma kinase. Driver oncogene mutations with approved therapies seldom coexist with a high expression of Programmed death‑ligand 1 (PD‑L1). The present case report describes a rare case of ROS1 rearrangement with high‑PD‑L1‑expressing occult lung adenocarcinoma. A 32‑year‑old woman presented with chest pain and a prolonged cough. Chest computed tomography (CT) revealed a 57x36‑mm tumor in the mediastinum, with no tumors detected in other regions. Positron emission tomography (PET)‑CT showed a strong fluorodeoxyglucose accumulation in the tumor (SUVmax 13.2). Mediastinal tumor resection was completely resected using a video‑assisted thoracic surgery approach. Pathological examination showed the tumor cells were positive for thyroid transcription factor 1, Napsin‑A, ROS1, and PD‑L1 (tumor proportion score >99%). ROS1 rearrangement was confirmed by fluorescence in situ hybridization. The mediastinal tumor was diagnosed as mediastinal lymph node metastasis of ROS1‑rearranged PD‑L1 high‑expression undifferentiated lung adenocarcinoma (pathological stage 3, TxN2M0). Two months after the operation, the CT scan showed multiple mediastinum lymph nodes metastases with rapid tumor growth. The patient achieved a complete response after three cycles of S‑1 plus cisplatin with concurrent radiotherapy 60 Gy/30 Fr.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

ROS1‑rearranged high‑PD‑L1‑expressing lung adenocarcinoma manifesting as mediastinal tumor: A case report

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