KRAS and MET Co-Mutation in One Lesion and EGFR Mutation in Another Lesion of Early-Stage Synchronous Multiple Lung Adenocarcinomas: A Case Report.
Takayasu Ito, Ken Onodera, Naoya Ishida et al.
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Case in brief
A 68-year-old man had three ground-glass opacities in the left upper lobe. After thoracoscopic left upper division segmentectomy, pathology showed synchronous early-stage lung adenocarcinomas with differing degrees of invasiveness. Genetic testing found MET exon 14 skipping and KRAS mutations together in one lesion, and an EGFR L858R mutation in another. His postoperative course was uneventful; without adjunctive treatment, no recurrence had been detected at 1 year and 9 months after surgery.
What made this case unusual
One adenocarcinoma harbored both MET exon 14 skipping and KRAS mutations, while a separate ground-glass lesion carried an EGFR mutation—distinct molecular profiles among synchronous tumors.
Diagnostic / clinical pearl
Synchronous lung adenocarcinomas may have different driver mutations, and a single lesion may harbor co-mutations; molecular findings from one tumor should not be assumed to represent the others.