{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T15:29:15Z","timestamp":1791041355296,"version":"4.1.0"},"reference-count":5,"publisher":"Wiley","issue":"34","license":[{"start":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T00:00:00Z","timestamp":1698969600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Thoracic Cancer"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>A 76\u2010year\u2010old man was referred to our hospital with a cough. Chest computed tomography (CT) revealed a 45\u2010mm mass in the lingular segment of the left upper lobe. Transbronchial tumor biopsies showed adenocarcinoma. Contrast\u2010enhanced CT and bone scintigraphy revealed lung, pleura, and bone metastases. The patient was diagnosed with left upper lobe adenocarcinoma cT2bN3M1c stage IVB. A genetic analysis of the primary tumor using the Oncomine Dx Target Test Multi\u2010CDx system revealed positivity for epidermal growth factor receptor (EGFR) (L858R) and CTNNB1 mutations. Based on these findings, the patient was treated with osimertinib (80 mg\/day) as first\u2010line therapy. Six months later, the tumor increased in size, indicating progressive disease. Osimertinib was stopped and second\u2010line therapy with carboplatin (area under the curve 5) and pemetrexed (500 mg\/m2) was initiated. After three cycles of chemotherapy, the patient developed dementia and disorientation. Contrast\u2010enhanced magnetic resonance imaging of the head showed miliary brain metastases. Miliary dissemination is a rare form of brain metastasis. Miliary patterns of lung metastases have been strongly associated with the EGFR exon 19 deletion. The radiological features of miliary brain metastases of non\u2010small cell lung cancer with the exon 19 deletion have been reported. To the best of our knowledge, this is the first case report of lung cancer with miliary brain metastases and co\u2010mutations of EGFR (L858R) and CTNNB1. In conclusion, co\u2010mutations of EGFR (L858R) and CTNNB1 and the discontinuation of EGFR\u2010tyrosine kinase inhibitor may contribute to the development of miliary brain metastases. Further case studies are warranted.<\/jats:p>","DOI":"10.1111\/1759-7714.15144","type":"journal-article","created":{"date-parts":[[2023,11,3]],"date-time":"2023-11-03T08:39:55Z","timestamp":1699000795000},"page":"3419-3420","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Miliary brain metastases from lung adenocarcinoma with <scp>EGFR<\/scp> (<scp>L858R<\/scp>) and <scp>CTNNB1<\/scp> mutations"],"prefix":"10.1111","volume":"14","author":[{"given":"Michihiro","family":"Kunishige","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine National Hospital Organization Kochi Hospital  Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1541-9747","authenticated-orcid":false,"given":"Eiji","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Investigation National Hospital Organization Kochi Hospital  Kochi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,11,3]]},"reference":[{"key":"e_1_2_3_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneurpsyc.1951.02320020033003"},{"key":"e_1_2_3_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00234-006-0152-6"},{"key":"e_1_2_3_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2019.10.021"},{"key":"e_1_2_3_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-18-1942"},{"key":"e_1_2_3_6_1","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-11-1468"}],"container-title":["Thoracic Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/1759-7714.15144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,19]],"date-time":"2023-12-19T05:33:25Z","timestamp":1702964005000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/1759-7714.15144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,3]]},"references-count":5,"journal-issue":{"issue":"34","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/1759-7714.15144"],"URL":"https:\/\/doi.org\/10.1111\/1759-7714.15144","archive":["Portico"],"relation":{},"ISSN":["1759-7706","1759-7714"],"issn-type":[{"value":"1759-7706","type":"print"},{"value":"1759-7714","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,3]]},"assertion":[{"value":"2023-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-10-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-11-03","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}