Diaphragmatic hernia during treatment of lung cancer harboring an EGFR mutation. Issue 7 (21st July 2021)

• Record Type: Journal Article
• Authors: Konno-Yamamoto, Aya; Narumoto, Osamu; Yamamoto, Shota; Yamaguchi, Miho; Motoyoshi, Makoto; Inoue, Yuta; Fukami, Takeshi; Tamura, Atsuhisa; Matsui, Hirotoshi
• Is Part Of: Oxford medical case reports. Volume 2021:Issue 7(2021)
• Publication Date: 2021-07-21
• Subjects: Clinical medicine -- Case studies -- Periodicals; 616.09
• DOI: 10.1093/omcr/omab054
• Languages: English
• ISSNs: 2053-8855

Abstract

ABSTRACT: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are a first-line treatment for patients with nonsmall-cell lung cancer harboring EGFR mutations. We report a 65-year-old Japanese woman with nonsmall-cell lung cancer taking an EGFR-TKI who visited the emergency department with acute nausea and vomiting. Imaging studies demonstrated an incarcerated diaphragmatic hernia. Urgent diagnostic surgery revealed a gap in the diaphragm acting as a hernial orifice, where a metastatic tumor was detected. We consider that regression of the diaphragmatic metastasis by EGFR-TKI therapy resulted in perforation of the diaphragm, causing the diaphragmatic hernia. Gastrointestinal adverse events, e.g. nausea, vomiting and diarrhea, are common during EGFR-TKI treatment. However, this case suggests that in patients with diaphragmatic metastasis, we should consider the rare possibility of diaphragmatic perforation and a subsequent hernia.