Recurrent EML4-ALK-associated lung adenocarcinoma with a slow clinical course

Lung Cancer. 2010 Sep;69(3):361-4. doi: 10.1016/j.lungcan.2010.05.019. Epub 2010 Jun 17.


The fusion gene EML4-ALK (echinoderm microtubule-associated protein-like 4 gene and the anaplastic lymphoma kinase gene) was recently identified as a novel genetic alteration in non-small-cell lung cancer. The clinicopathological features of EML4-ALK-positive adenocarcinoma are reported to include its high incidence in young, non-smoking patients, tumors that show distinct solid or acinar growth patterns with or without signet-ring cell histology, and its mutually exclusive occurrence with mutations in EGFR and KRAS. However, the clinical findings have not been well described. Here, we report a case of EML4-ALK-positive lung adenocarcinoma that showed multiple metachronous lesions on the pleura and pulmonary field, suspected to be a recurrence of lung adenocarcinoma after a 20-year disease-free interval. The slow clinical course may be characteristic of EML4-ALK-positive lung adenocarcinoma. Therefore, long-term observation of patients with EML4-ALK-positive lung adenocarcinomas is required after surgery.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / genetics
  • Adenocarcinoma / pathology
  • Adenocarcinoma / physiopathology
  • Adult
  • Biomarkers, Tumor / genetics
  • Diagnosis, Differential
  • ErbB Receptors / genetics
  • Female
  • Humans
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / pathology
  • Lung Neoplasms / physiopathology
  • Mutation / genetics
  • Neoplasm Recurrence, Local
  • Oncogene Proteins, Fusion / genetics
  • Pleural Neoplasms / diagnosis*
  • Pleural Neoplasms / genetics
  • Pleural Neoplasms / pathology
  • Pleural Neoplasms / physiopathology
  • Proto-Oncogene Proteins / genetics
  • Proto-Oncogene Proteins p21(ras)
  • Time Factors
  • Tomography, X-Ray Computed
  • ras Proteins / genetics


  • Biomarkers, Tumor
  • EML4-ALK fusion protein, human
  • KRAS protein, human
  • Oncogene Proteins, Fusion
  • Proto-Oncogene Proteins
  • EGFR protein, human
  • ErbB Receptors
  • Proto-Oncogene Proteins p21(ras)
  • ras Proteins