Lung Cancer with Concomitant Double Gene Mutation

A patient presenting with concomitant epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) translocation is very rare. We report a non-small cell lung cancer (NSCLC) patient with concomitant EGFR (exon 19-del) mutation and ALK rearrangement. The positron emission tomography-computed tomography (PET-CT) scan revealed a highly metabolic mass lesion in the left lower lobe, measured 5.0 cm in the largest dimension in the S6 segment. Transbronchial lung biopsy (TBLB) showed the pathological diagnosis of invasive adenocarcinoma. Thus, the patient underwent left lower lobectomy and hilar-mediastina lymph node dissection (pT2N0M0). The tumor harbor an ALK (D5F3 +) rearrangement and EGFR (exon 19-del) mutation. The patient initially received four cycles of chemotherapy (pemetrexed and carboplatin), and achieved partial response (PR).