Elsevier

Lung Cancer

Volume 73, Issue 3, September 2011, Pages 379-380
Lung Cancer

Case report
Detection of the EGFR mutation in exhaled breath condensate from a heavy smoker with squamous cell carcinoma of the lung

https://doi.org/10.1016/j.lungcan.2011.05.018Get rights and content

Abstract

A 61-year-old male smoker (40 pack-years) presented with right chest pain. Computed tomography of the chest revealed a cavitary mass in the right lower lobe. A transbronchial biopsy showed squamous cell carcinoma. We examined epidermal growth factor receptor (EGFR) mutations in exhaled breath condensate (EBC). The DNA extracted from his EBC showed a deletion mutation in exon 19. Subsequently, the del E746-A750 mutation in exon 19 in a transbronchial tissue specimen was confirmed. Although he underwent whole-brain irradiation against multiple brain metastases, he had paralysis of the left side of the body and his performance status was 3. The patient was treated with gefitinib. He had marked tumor regression and no symptoms. Although only a small percentage of heavy smokers with squamous cell carcinoma harbor EGFR mutations, they probably benefit from EGFR-tyrosine kinase inhibitors. EGFR mutation status in the patients having such clinical features might be examined.

Introduction

Patients with squamous cell carcinoma of the lung had rarely epidermal growth factor receptor (EGFR) mutations especially in heavy smoker. Less than 5% of the squamous cell carcinoma carried EGFR mutation [1]. Actually, in recently published two papers which proved the first-line gefitinib was effective for the advanced non-small cell lung cancer harboring EGFR mutation, the squamous cell carcinoma was only one in 172 [2] and five in 225 patients [3]. We previously showed that measurement of exhaled breath condensate (EBC) biomarkers was a non-invasive and useful way to evaluate airway inflammation in patients with asthma [4]. A biomarker panel with oncogenes, suppressor genes, and protein factors using exhaled breath condensate (EBC) has been explored in lung cancer patients [5].

Section snippets

Case presentation

A 61-year-old male smoker (40 pack-years) presented with right chest pain. Radiograph and computed tomography of the chest revealed a cavitary mass in the right lower lobe (Fig. 1A and B). Flexible bronchoscopy revealed a tumor in the intermediate bronchus. A transbronchial biopsy showed squamous cell carcinoma. Magnetic resonance imaging of the brain showed multiple metastases. Although he underwent whole-brain irradiation, he had paralysis of the left side of the body and his performance

Discussion

Although only a small percentage of heavy smokers with squamous cell carcinoma harbor EGFR mutations [1], they may benefit from gefitinib treatment [2], [3]. Based on this experience, we have examined the EGFR mutation status in heavy smokers with squamous cell carcinoma.

We might have detected the EGFR mutation in EBC by chance, because Paradiso et al. reported that EBC could not be used to investigate somatic mutations of EGFR [7]. In addition, the previous reports revealed that sufficient

Conclusion

A male, heavy smoker with squamous cell carcinoma was treated successfully with first-line gefitinib. EGFR mutation status in the patients having such clinical features might be examined. This case was successfully evaluated its EGFR mutation status from EBC.

Conflict of interest

The authors have no conflict of interest.

References (10)

There are more references available in the full text version of this article.
View full text