Infectious cerebral thromboembolism in a patient with lung cancer during long-term administration of gefitinib: a case report

DOI 機関リポジトリ HANDLE
  • Shimada Midori
    Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital
  • Fukuda Minoru
    Nagasaki University Hospital Clinical Oncology Center
  • Onn Yumi
    Department of Radiology, Chikugo City Hospital
  • Abe Noriko
    Nagasaki Harbor Medical Center City Hospital
  • Irie Junji
    Nagasaki Harbor Medical Center City Hospital
  • Kitazaki Takeshi
    Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital
  • Hashiguchi Kohji
    Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital
  • Fukuda Masaaki
    Department of Respiratory Medicine, Japanese Red Cross Nagasaki Genbaku Hospital
  • Nakamura Yoichi
    Second Department of Internal Medicine, Nagasaki University Hospital
  • Suyama Naofumi
    Nagasaki Harbor Medical Center City Hospital
  • Ashizawa Kazuto
    Nagasaki University Hospital Clinical Oncology Center
  • Kohno Shigeru
    Second Department of Internal Medicine, Nagasaki University Hospital

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Introduction 　Gefitinib is a molecularly targeted drug for oral administration, a selective epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI). It is effective for patients with lung cancer who have EGFR mutation and enables long-term survival of patients with advanced disease. Case presentation 　An 84-year-old Asian female with lung cancer (adenocarcinoma, cT4N3M1b stage IV PUL BRA OSS ADR) was treated by gefitinib for two years. The primary tumor was markedly reduced, and bone metastasis had almost disappeared. However, the patient became unconsciousness with general edema and died two days after falling unconsciousness. In the autopsy, it was diagnosed as infectious cerebral thromboembolism due to infectious endocarditis. The cause of death was cardiac tamponade. Conclusions 　While long-term survival can be expected in patients with advanced lung cancer by molecular-targeted agents, cautious management is warranted for complications, the same as for the primary disease.

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