{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T12:13:30Z","timestamp":1753877610477,"version":"3.41.2"},"reference-count":10,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T00:00:00Z","timestamp":1626912000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,7,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>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.<\/jats:p>","DOI":"10.1093\/omcr\/omab054","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T16:42:40Z","timestamp":1626972160000},"source":"Crossref","is-referenced-by-count":0,"title":["Diaphragmatic hernia during treatment of lung cancer harboring an EGFR mutation"],"prefix":"10.1093","volume":"2021","author":[{"given":"Aya","family":"Konno-Yamamoto","sequence":"first","affiliation":[{"name":"Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Narumoto","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shota","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"},{"name":"Department of Radiology, Tokai University Hachioji Hospital, Tokai University School of Medicine, Hachioji, Tokyo 192-0032, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miho","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Makoto","family":"Motoyoshi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuta","family":"Inoue","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Fukami","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsuhisa","family":"Tamura","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotoshi","family":"Matsui","sequence":"additional","affiliation":[{"name":"Center for Pulmonary Disease, National Hospital Organization Tokyo Hospital, Kiyose, Tokyo 204-8585, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,7,21]]},"reference":[{"key":"2021072216423357300_ref1","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1200\/JCO.2012.43.5578","article-title":"Gastric perforation secondary to regression of lung adenocarcinoma after gefitinib treatment","volume":"31","author":"Chung","year":"2013","journal-title":"J Clin Oncol"},{"key":"2021072216423357300_ref2","first-page":"34","article-title":"Duodenal perforation secondary to erlotinib therapy in a patient with non-small cell lung cancer","volume":"116","author":"Islam","year":"2017","journal-title":"WMJ"},{"key":"2021072216423357300_ref3","doi-asserted-by":"crossref","DOI":"10.21037\/amj.2020.02.07","article-title":"Non-small cell lung cancer, pleural effusion and carcinomatosis: always a criterion of inoperability?","volume":"5","author":"Yablonskii","year":"2020","journal-title":"AME Med J"},{"key":"2021072216423357300_ref4","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1016\/S0022-5223(97)70203-4","article-title":"Resection of lung cancer invading the diaphragm","volume":"114","author":"Weksler","year":"1997","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2021072216423357300_ref5","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/00005382-199807000-00009","article-title":"Helical computed tomography diagnosis of pleural dissemination in lung cancer: comparison of thick-section and thin-section helical computed tomography","volume":"13","author":"Mori","year":"1998","journal-title":"J Thorac Imaging"},{"key":"2021072216423357300_ref6","first-page":"1194","article-title":"Diagnosis of pleural dissemination lung cancer by thin-section CT - 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