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Attiki: International Institute of Anticancer Research
Erscheinungsjahr
2009
Quelle
MEDLINE
Beschreibungen/Notizen
A 51-year-old female presented with left facial palsy. She had adenocarcinoma of the lung with multiple brain metastases.
The primary tumor regressed after treatment with gefitinib, however, neurological symptoms progressed rapidly because of meningeal
carcinomatosis, when a deletion mutation in exon 19 of the epidermal growth factor receptor in cells from her cerebrospinal
fluid was detected. After performing lumbo-peritoneal shunting, her symptoms improved dramatically and she had been well without
peritoneal dissemination for 15 months, continuing gefitinib treatment. Finally, she died 18 months after lumbo-peritoneal
shunting. A T790M acquired-resistance mutation in exon 20 of the epidermal growth factor receptor was found from her mesenteric
lymph nodes and cerebrospinal fluid at autopsy. A lumbo-peritoneal shunt might be considered for meningeal carcinomatosis
refractory to gefitinib treatment without an emergence of a T790M mutation.