A Prompt Diagnosis of Ascites and Dramatic Effect of Alectinib for Advanced Lung Adenocarcinoma Harboring EML4-ALK Fusion

Takahiro Baba; Hirofumi Inoue; Hiromi Matsuoka; Mio Kyakuno; Yusuke Yoshinaga; Tetsuya Takeguchi; Miho Fujiwara; Kotaro Yamada; Eri Nakamura; Ayako Morita; Naofumi Hara; Kiichiro Ninomiya; Hisao Higo; Masanori Fujii; Eiki Ichihara; Kammei Rai; Kadoaki Ohashi; Katsuyuki Hotta; Masahiro Tabata; Yoshinobu Maeda; Yosuke Togashi; Go Makimoto

doi:10.2169/internalmedicine.5397-25

A Prompt Diagnosis of Ascites and Dramatic Effect of Alectinib for Advanced Lung Adenocarcinoma Harboring EML4-ALK Fusion

Takahiro Baba
, Hirofumi Inoue
, Hiromi Matsuoka
, Mio Kyakuno
, Yusuke Yoshinaga
, Tetsuya Takeguchi
, Miho Fujiwara
, Kotaro Yamada
, Eri Nakamura
, Ayako Morita
, Naofumi Hara
, Kiichiro Ninomiya
, Hisao Higo
, Masanori Fujii
, Eiki Ichihara
, Kammei Rai
, Kadoaki Ohashi
, Katsuyuki Hotta
, Masahiro Tabata
, Yoshinobu Maeda

Yosuke Togashi, Go Makimoto

University Hospital

Research output: Contribution to journal › Article › peer-review

1 Citation (Scopus)

Abstract

A 75-year-old never-smoker woman presented with dyspnea and loss of appetite. A mass was identified in the left upper lobe of the lung, and the patient was referred to our hospital. Despite the diagnosis of lung adenocarcinoma via bronchoscopy, anaplastic lymphoma kinase (ALK) immunostaining was negative. Rapid weight gain and abdominal distension caused by ascites prompted fluid testing using the AmoyDx® Pan Lung Cancer PCR Panel. EML4-ALK fusion was confirmed, and alectinib therapy was initiated immediately. The tumor size had decreased significantly, and the patient was discharged on day 34. This case highlights the necessity of multiplex genetic testing even when ALK immunostaining is negative.

Original language	English
Pages (from-to)	3413-3418
Number of pages	6
Journal	Internal Medicine
Volume	64
Issue number	23
DOIs	https://doi.org/10.2169/internalmedicine.5397-25
Publication status	Published - Dec 1 2025

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

AmoyDx® Pan Lung Cancer PCR Panel
EML4-ALK
alectinib
lung adenocarcinoma

ASJC Scopus subject areas

Internal Medicine

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10.2169/internalmedicine.5397-25

Cite this

Baba, T., Inoue, H., Matsuoka, H., Kyakuno, M., Yoshinaga, Y., Takeguchi, T., Fujiwara, M., Yamada, K., Nakamura, E., Morita, A., Hara, N., Ninomiya, K., Higo, H., Fujii, M., Ichihara, E., Rai, K., Ohashi, K., Hotta, K., Tabata, M., ... Makimoto, G. (2025). A Prompt Diagnosis of Ascites and Dramatic Effect of Alectinib for Advanced Lung Adenocarcinoma Harboring EML4-ALK Fusion. Internal Medicine, 64(23), 3413-3418. https://doi.org/10.2169/internalmedicine.5397-25

Baba, T, Inoue, H, Matsuoka, H, Kyakuno, M, Yoshinaga, Y, Takeguchi, T, Fujiwara, M, Yamada, K, Nakamura, E, Morita, A , Hara, N , Ninomiya, K , Higo, H , Fujii, M , Ichihara, E , Rai, K , Ohashi, K , Hotta, K, Tabata, M, Maeda, Y, Togashi, Y & Makimoto, G 2025, 'A Prompt Diagnosis of Ascites and Dramatic Effect of Alectinib for Advanced Lung Adenocarcinoma Harboring EML4-ALK Fusion', Internal Medicine, vol. 64, no. 23, pp. 3413-3418. https://doi.org/10.2169/internalmedicine.5397-25

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title = "A Prompt Diagnosis of Ascites and Dramatic Effect of Alectinib for Advanced Lung Adenocarcinoma Harboring EML4-ALK Fusion",

abstract = "A 75-year-old never-smoker woman presented with dyspnea and loss of appetite. A mass was identified in the left upper lobe of the lung, and the patient was referred to our hospital. Despite the diagnosis of lung adenocarcinoma via bronchoscopy, anaplastic lymphoma kinase (ALK) immunostaining was negative. Rapid weight gain and abdominal distension caused by ascites prompted fluid testing using the AmoyDx{\textregistered} Pan Lung Cancer PCR Panel. EML4-ALK fusion was confirmed, and alectinib therapy was initiated immediately. The tumor size had decreased significantly, and the patient was discharged on day 34. This case highlights the necessity of multiplex genetic testing even when ALK immunostaining is negative.",

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author = "Takahiro Baba and Hirofumi Inoue and Hiromi Matsuoka and Mio Kyakuno and Yusuke Yoshinaga and Tetsuya Takeguchi and Miho Fujiwara and Kotaro Yamada and Eri Nakamura and Ayako Morita and Naofumi Hara and Kiichiro Ninomiya and Hisao Higo and Masanori Fujii and Eiki Ichihara and Kammei Rai and Kadoaki Ohashi and Katsuyuki Hotta and Masahiro Tabata and Yoshinobu Maeda and Yosuke Togashi and Go Makimoto",

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AU - Baba, Takahiro

AU - Inoue, Hirofumi

AU - Matsuoka, Hiromi

AU - Kyakuno, Mio

AU - Yoshinaga, Yusuke

AU - Takeguchi, Tetsuya

AU - Fujiwara, Miho

AU - Yamada, Kotaro

AU - Nakamura, Eri

AU - Morita, Ayako

AU - Hara, Naofumi

AU - Ninomiya, Kiichiro

AU - Higo, Hisao

AU - Fujii, Masanori

AU - Ichihara, Eiki

AU - Rai, Kammei

AU - Ohashi, Kadoaki

AU - Hotta, Katsuyuki

AU - Tabata, Masahiro

AU - Maeda, Yoshinobu

AU - Togashi, Yosuke

AU - Makimoto, Go

PY - 2025/12/1

Y1 - 2025/12/1

N2 - A 75-year-old never-smoker woman presented with dyspnea and loss of appetite. A mass was identified in the left upper lobe of the lung, and the patient was referred to our hospital. Despite the diagnosis of lung adenocarcinoma via bronchoscopy, anaplastic lymphoma kinase (ALK) immunostaining was negative. Rapid weight gain and abdominal distension caused by ascites prompted fluid testing using the AmoyDx® Pan Lung Cancer PCR Panel. EML4-ALK fusion was confirmed, and alectinib therapy was initiated immediately. The tumor size had decreased significantly, and the patient was discharged on day 34. This case highlights the necessity of multiplex genetic testing even when ALK immunostaining is negative.

AB - A 75-year-old never-smoker woman presented with dyspnea and loss of appetite. A mass was identified in the left upper lobe of the lung, and the patient was referred to our hospital. Despite the diagnosis of lung adenocarcinoma via bronchoscopy, anaplastic lymphoma kinase (ALK) immunostaining was negative. Rapid weight gain and abdominal distension caused by ascites prompted fluid testing using the AmoyDx® Pan Lung Cancer PCR Panel. EML4-ALK fusion was confirmed, and alectinib therapy was initiated immediately. The tumor size had decreased significantly, and the patient was discharged on day 34. This case highlights the necessity of multiplex genetic testing even when ALK immunostaining is negative.

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KW - EML4-ALK

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KW - lung adenocarcinoma

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A Prompt Diagnosis of Ascites and Dramatic Effect of Alectinib for Advanced Lung Adenocarcinoma Harboring EML4-ALK Fusion

Abstract

UN SDGs

Keywords

ASJC Scopus subject areas

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