Unique Pattern of Metastasis to the Adnexa in ALK Rearranged Non-Small Cell Lung Cancer : Metastatic Non-Small Cell Lung Cancer

Purpose/Objective(s)NSCLC most commonly metastasizes to the brain, bone, liver, and adrenal glands. Recent observation of stage IV ALK rearranged NSCLC metastatic to the adnexa in our clinic led to the current study to estimate the frequency of metastasis to the female reproductive system.Materials/MethodsA retrospective chart review of female patients with stage IV ALK rearranged NSCLC was performed. Relevant charts were reviewed for pelvic imaging notable for ovarian, adnexal, or pelvic mass or enlargement.ResultsTwenty patients met the requirements for chart review: female, NSCLC, and the presence of an EML4-ALK. Of these 20 cases, 16 included imaging of the pelvis by computed tomography as part of work-up for systemic disease; 1 patient had prior hysterectomy-oophorectomy and was excluded. Five of 15 charts with pelvic imaging were notable for ovarian enlargement or mass. Two of these women underwent therapeutic intervention directed at their ovarian masses, tissue from 1 of these women demonstrated ALK positive NSCLC.ConclusionsThe finding of adnexal abnormalities in one-third of female clinic patients with NSCLC harboring an ALK rearrangement is compelling. Metastases to the adnexa in female patients with ALK positive NSCLC should be a consideration during work-up for systemic disease. Purpose/Objective(s)NSCLC most commonly metastasizes to the brain, bone, liver, and adrenal glands. Recent observation of stage IV ALK rearranged NSCLC metastatic to the adnexa in our clinic led to the current study to estimate the frequency of metastasis to the female reproductive system. NSCLC most commonly metastasizes to the brain, bone, liver, and adrenal glands. Recent observation of stage IV ALK rearranged NSCLC metastatic to the adnexa in our clinic led to the current study to estimate the frequency of metastasis to the female reproductive system. Materials/MethodsA retrospective chart review of female patients with stage IV ALK rearranged NSCLC was performed. Relevant charts were reviewed for pelvic imaging notable for ovarian, adnexal, or pelvic mass or enlargement. A retrospective chart review of female patients with stage IV ALK rearranged NSCLC was performed. Relevant charts were reviewed for pelvic imaging notable for ovarian, adnexal, or pelvic mass or enlargement. ResultsTwenty patients met the requirements for chart review: female, NSCLC, and the presence of an EML4-ALK. Of these 20 cases, 16 included imaging of the pelvis by computed tomography as part of work-up for systemic disease; 1 patient had prior hysterectomy-oophorectomy and was excluded. Five of 15 charts with pelvic imaging were notable for ovarian enlargement or mass. Two of these women underwent therapeutic intervention directed at their ovarian masses, tissue from 1 of these women demonstrated ALK positive NSCLC. Twenty patients met the requirements for chart review: female, NSCLC, and the presence of an EML4-ALK. Of these 20 cases, 16 included imaging of the pelvis by computed tomography as part of work-up for systemic disease; 1 patient had prior hysterectomy-oophorectomy and was excluded. Five of 15 charts with pelvic imaging were notable for ovarian enlargement or mass. Two of these women underwent therapeutic intervention directed at their ovarian masses, tissue from 1 of these women demonstrated ALK positive NSCLC. ConclusionsThe finding of adnexal abnormalities in one-third of female clinic patients with NSCLC harboring an ALK rearrangement is compelling. Metastases to the adnexa in female patients with ALK positive NSCLC should be a consideration during work-up for systemic disease. The finding of adnexal abnormalities in one-third of female clinic patients with NSCLC harboring an ALK rearrangement is compelling. Metastases to the adnexa in female patients with ALK positive NSCLC should be a consideration during work-up for systemic disease.