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Abstract：
The histological transformation from epidermal growth factor receptor (EGFR)-mutated adenocarcinoma (ADC) to squamous cell carcinoma (SCC) after tyrosine kinase inhibitor (TKI) treatment is rare. We present a case of a patient who transitioned from early-stage primary lung ADC with partial squamous differentiation, EGFR mutation and amplification, to adrenal gland metastasis as SCC with EGFR amplification disappearance 115-months after surgery, during which gefitinib and local radiotherapy were utilized for the metastasis in the right femoral head and mediastinal lymph nodes. This case might indicate a possible mechanism of EGFR inhibition resistance with SCC transition and EGFR amplification loss from the initially well-responding ADC, especially those with SCC or partial squamous differentiation. The optimal post-progression therapy for ADC-SCC patients is challenging and further studies are needed.
摘要：
酪氨酸激酶抑制剂（TKI）治疗后，从表皮生长因子受体（EGFR）突变的腺癌（ADC）到鳞状细胞癌（SCC）的组织学转变很少见。我们介绍了一例从早期原发性肺ADC转变为部分鳞状分化的患者，EGFR突变和扩增，肾上腺转移作为SCC与EGFR扩增消失手术后115个月，在此期间，吉非替尼和局部放疗用于右侧股骨头和纵隔淋巴结的转移。这种情况可能表明EGFR抑制抵抗与SCC转变和EGFR扩增从最初反应良好的ADC丢失的可能机制。尤其是SCC或部分鳞状细胞分化的患者。ADC-SCC患者的最佳进展后治疗具有挑战性，需要进一步的研究。
