First case report of lorlatinib in the treatment of ALK-fusion-positive lung adenocarcinoma with ovarian metastasis: Clinicopathological and molecular characterization.

BACKGROUND

Ovarian metastasis from anaplastic lymphoma kinase (ALK)-positive lung adenocarcinoma is exceedingly rare. Reporting such cases is vital for understanding its clinical management.

PATIENT CONCERNS: A 49-year-old woman presented with a 10-day history of amenorrhea and lower abdominal pain.

DIAGNOSES: Imaging revealed bilateral ovarian masses and liver nodules. Liver biopsy and genetic testing confirmed the diagnosis of stage IV EML4-ALK fusion-positive lung adenocarcinoma with ovarian and hepatic metastases.

INTERVENTIONS: First-line treatment with the third-generation ALK inhibitor lorlatinib (100 mg, once daily) was initiated.

OUTCOMES: The patient achieved a partial response with significant lesion regression and normalized tumor markers, sustained for over 12 months. No severe adverse events occurred.

LESSONS: This case underscores the importance of molecular profiling in diagnosing metastatic tumors and confirms lorlatinib as a highly effective first-line therapy for ALK-positive non-small cell lung cancer with atypical metastases.