Testicular metastasis from ALK-rearranged non-small cell lung cancer
Section snippets
Clinical practice points
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Anaplastic lymphoma kinase (ALK) gene rearrangements can be identified in approximately 5% of non-small cell lung cancers
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ALK-rearranged non-small cell lung cancers are associated with a distinct set of clinical and pathological features, and have been shown to respond to targeted therapy with ALK-inhibitors.
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Here, we report a case of testicular metastasis from an ALK-rearranged non-small cell lung cancer.
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We discuss the distinct features associated with ALK-rearranged NSCLC, including patterns of
Case report
A previously well 31 year old male presented with a six month history of gradually increasing cough, wheeze and dyspnoea. Serial chest x-rays revealed non-resolving bilateral pulmonary infiltrates, and he was referred for further investigation. He had a minimal smoking history of less than one hundred cigarettes in his lifetime.
Initial physical examination was unremarkable apart from the presence of a firm left testicular mass Blood parameters including serum alpha-fetoprotein (AFP) and
Discussion
Rearrangements of the anaplastic lymphoma kinase (ALK) gene are present in 3 to 5% of non–small-cell lung cancers (NSCLCs) [3], [4]. They define a distinct molecular subgroup of NSCLC that typically occurs in younger patients who have never smoked or have a history of light smoking, with adenocarcinoma histology. Additional information about the phenotypic features of this uncommon variant of NSCLC is emerging.
A retrospective analysis of the patterns of metastatic spread of non-small cell lung
Conclusion
Patients with ALK-rearranged lung cancers should undergo careful clinical review, including evaluation of atypical sites of disease such as the testes. In our patient, resection of the initial testicular tumour was performed for both diagnostic and therapeutic purposes. However, the presence of a testicular metastasis could also have therapeutic relevance, with the penetrance of current molecular targeted therapies to this site remaining unclear.
Conflict of Interest
No conflict of interest to declare.
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