[A case of bronchioloalveolar carcinoma successfully treated with low-dose, alternate-day administration of erlotinib].

Erlotinib is a selective epidermal growth factor receptor(EGFR)tyrosine kinase inhibitor, which shows favorable antitumor activity against chemorefractory lung carcinoma, especially with EGFR gene mutations. We experienced a case in which oxy- genation and performance status improved in with low-dose erlotinib of 100mg/day administered every other day incidental- ly, although a dose of erlotinib 150mg/day daily is encouraged by the RECIST guideline. A 77-year-old male was diagnosed with bronchioloalveolar carcinoma(BAC)and given first-line combination chemotherapy of carboplatin and pemetrexed. However, antitumor activity was not satisfactory. His performance status(PS)was scored as 2 and home oxygen therapy (HOT)was introduced. As second-line chemotherapy, erlotinib was administered 100mg/day daily. However, the patient took the medication every other day at his own discretion, due to severe eruption and itching sensation. Since this case is classified as a nonmeasurable lesion according to the RECIST guideline, it was difficult to measure antitumor activity by tumor size. But improvement of oxygenation, with a performance status score of 0 and normalization of serum CEA level suggested that erlonitib administration of 100mg/day every other day showed antitumor activity.

[A case of extramedullary plasmacytoma of the lung diagnosed by video-assisted thoracic surgery].

A 69-year-old man who had had a history of abnormal chest radiograph was admitted. Chest computed tomography showed an 18 x 18 mm apparently-circumscribed mass in the right posterior-basal segment. We performed right lower lobe wedge resection via video-assisted thoracic surgery to establish a definitive diagnosis. The mass was an apparently-circumscribed, gray and solid tumor, the microscopic findings of which included diffuse proliferation of plasma cells with an abnormal profile. Immunohistochemical staining revealed IgG-kappa light chain monoclonality. Absence of M protein in the serum and urine was confirmed. Bone-marrow puncture and positron-emission tomography revealed normal findings. Thus a diagnosis of extramedullary plasmacytoma (EMP) of the lung was made. We report trends of the immunoglobulin isotype of EMP in Japan. Since it has been reported that some of the cases in EMP progress to multiple myeloma (MM), careful observation and follow-up is needed hereafter. In the present case, no recurrence or progress to MM was observed within the first year after surgery.