# A Case of Multiple Primary Pulmonary Neuroendocrine Carcinoma with EML4-ALK Fusion Gene Positive

## TL;DR

A woman with no smoking history developed two separate lung neuroendocrine cancers, both showing EML4-ALK fusion and responding well to targeted therapy.

## Contribution

Reports a rare case of multiple primary pulmonary neuroendocrine carcinomas with EML4-ALK fusion and successful ALK-TKI treatment.

## Key findings

- Two distinct lung lesions were diagnosed as LCNEC and SCLC with EML4-ALK fusion confirmed by NGS.
- The patient showed significant clinical response to ALK tyrosine kinase inhibitors.
- EML4-ALK fusion may be a therapeutic target in neuroendocrine carcinomas.

## Abstract

神经内分泌癌（neuroendocrine carcinoma, NEC）属于高增殖活性的神经内分泌肿瘤，具有侵袭性强、预后差等特点。本文报道1例既往健康无吸烟史的女性患者，其先后在不同侧肺叶发生NEC，苏木精-伊红（hematoxylin-eosin, HE）染色病理诊断分别为肺大细胞神经内分泌癌（large cell neuroendocrine carcinoma, LCNEC）与小细胞肺癌（small cell lung cancer, SCLC），分别对上述病变组织进行二代测序（next-generation sequencing, NGS），结果均存在棘皮动物微管相关蛋白4-间变性淋巴瘤激酶（echinoderm microtubule-associated protein-like 4-anaplastic lymphoma kinase, EML4-ALK）融合突变，且患者在ALK-酪氨酸激酶抑制剂（tyrosine kinase inhibitors, TKIs）靶向治疗中取得了显著的治疗效果。