Case Report
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World J Respirol. Jul 28, 2013; 3(2): 38-43
Published online Jul 28, 2013. doi: 10.5320/wjr.v3.i2.38
EGFR mutation identifies distant squamous cell carcinoma as metastasis from lung adenocarcinoma
Nobuhiro Kanaji, Shuji Bandoh, Toshitetsu Hayashi, Reiji Haba, Naoki Watanabe, Tomoya Ishii, Asako Kunitomo, Takayuki Takahama, Akira Tadokoro, Osamu Imataki, Hiroaki Dobashi, Takuya Matsunaga
Nobuhiro Kanaji, Shuji Bandoh, Naoki Watanabe, Tomoya Ishii, Asako Kunitomo, Takayuki Takahama, Akira Tadokoro, Osamu Imataki, Hiroaki Dobashi, Takuya Matsunaga, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Toshitetsu Hayashi, Reiji Haba, Department of Diagnostic Pathology, Faculty of Medicine, Kagawa University, Kagawa 761-0793, Japan
Author contributions: Kanaji N acquired the patient data, searched the literature, and drafted the manuscript; Bandoh S, Imataki O, Dobashi H, and Matsunaga T made revisions to the manuscript; Watanabe N, Ishii T, Kunitomo A, Takahama T, and Tadokoro A performed the bronchoscopic examination; Hayashi T and Haba R performed the histopathological evaluation of the specimens.
Correspondence to: Nobuhiro Kanaji, MD, PhD, Division of Endocrinology and Metabolism, Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. kanaji@med.kagawa-u.ac.jp
Telephone: +81-87-8912145 Fax: +81-87-8912147
Received: March 18, 2013
Revised: May 7, 2013
Accepted: June 1, 2013
Published online: July 28, 2013
Processing time: 121 Days and 23.3 Hours
Core Tip

Core tip: A tumor in the femur was identified genetically as a lung cancer metastasis. This case suggests that a matching epidermal growth factor receptor (EGFR) mutation in a distant lesion can validate a diagnosis of lung cancer metastasis, even if it differs histologically from the primary lesion. To the best of our knowledge, this is the first report showing the use of EGFR genetic analysis to identify a distant lesion as a lung cancer metastasis. In the era of molecularly-targeted treatments for non-small cell lung cancer, combined pathological diagnosis and genetic analysis could lead to more precise diagnoses and better understanding of histogenesis and more appropriate therapeutic selections.