{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T08:03:24Z","timestamp":1779782604343,"version":"3.53.1"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>Combined small-cell lung carcinoma is a rare and heterogeneous lung cancer characterized by the coexistence of small-cell and non-small-cell components. Concurrent epidermal growth factor receptor mutation and anaplastic lymphoma kinase rearrangement in combined small-cell lung carcinoma is extremely uncommon and presents diagnostic and therapeutic challenges. We report a 63-year-old man presenting with cough and right-sided chest pain. Imaging revealed a right lower lobe mass with mediastinal lymphadenopathy. Initial biopsy showed adenocarcinoma without actionable mutations. Following a limited response to neoadjuvant chemotherapy, right lower lobectomy was performed. Histopathological examination revealed combined small-cell carcinoma and adenocarcinoma, while molecular analysis identified concurrent epidermal growth factor receptor exon 19 deletion and anaplastic lymphoma kinase rearrangement. Lymph nodes were negative for metastasis. Postoperative targeted therapy was initiated, and follow-up imaging showed no evidence of recurrence. This case highlights tumour heterogeneity and the importance of comprehensive pathological and molecular evaluation in guiding personalized therapy.<\/jats:p>","DOI":"10.1177\/2050313x261452412","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T06:57:53Z","timestamp":1779519473000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical resection reveals combined small-cell lung carcinoma and adenocarcinoma with dual epidermal growth factor receptor and anaplastic lymphoma kinase alterations following neoadjuvant chemotherapy: A rare case"],"prefix":"10.1177","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5160-3875","authenticated-orcid":false,"given":"Joshua Evan","family":"Wijaya","sequence":"first","affiliation":[{"name":"Department of Thoracic, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ati","family":"Budiluhur","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1284-2099","authenticated-orcid":false,"given":"Harvey","family":"Romolo","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4286-9625","authenticated-orcid":false,"given":"Abdurrahman","family":"Hadi","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-9320-5263","authenticated-orcid":false,"given":"Adityo","family":"Budiarso","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arif Riswahyudi","family":"Hanafi","sequence":"additional","affiliation":[{"name":"Department of Thoracic, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1060-7979","authenticated-orcid":false,"given":"Grace","family":"Shalmont","sequence":"additional","affiliation":[{"name":"Department of Pathology, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noorwati","family":"Sutandyo","sequence":"additional","affiliation":[{"name":"Department of Hematology &amp; Cellular Therapy, Dharmais Cancer Hospital, Jakarta, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2017.00193"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2017.10.010"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S159057"},{"issue":"9","key":"e_1_3_3_5_2","first-page":"3864","article-title":"Combined small cell lung cancer: current progress and unmet needs","volume":"13","author":"Zeng C","year":"2023","unstructured":"Zeng C, Qiu G, Xie X, et al. Combined small cell lung cancer: current progress and unmet needs. Am J Cancer Res 2023; 13(9): 3864\u20133874.","journal-title":"Am J Cancer Res"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijpm.ijpm_939_23"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2018.09.101"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mds525"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.13716"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.830849"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2017.01.07"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.2482\/haigan.51.820"},{"issue":"1","key":"e_1_3_3_13_2","first-page":"51","article-title":"Treatments for combined small cell lung cancer patients: a SEER-based analysis","volume":"9","author":"He J","year":"2020","unstructured":"He J, Shen J, Pan H, et al. Treatments for combined small cell lung cancer patients: a SEER-based analysis. Transl Lung Cancer Res 2020; 9(1): 51\u201361.","journal-title":"Transl Lung Cancer Res"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41379-021-00943-2"},{"key":"e_1_3_3_15_2","first-page":"43","article-title":"New advances in understanding the mechanisms and treatment challenges of ALK-targeted therapy resistance in lung cancer","volume":"8","author":"Long M","year":"2025","unstructured":"Long M, Peng S, Wen Q, et al. New advances in understanding the mechanisms and treatment challenges of ALK-targeted therapy resistance in lung cancer. Cancer Drug Resist 2025; 8:43.","journal-title":"Cancer Drug Resist"},{"issue":"11","key":"e_1_3_3_16_2","first-page":"100405","article-title":"Potential therapeutic strategy for EGFR-mutant lung cancer with concomitant EML4\u2013ALK rearrangement\u2014combination of EGFR tyrosine kinase inhibitors and ALK inhibitors","volume":"3","author":"Huang MH","year":"2022","unstructured":"Huang MH, Lee JH, Hung PS, et al. Potential therapeutic strategy for EGFR-mutant lung cancer with concomitant EML4\u2013ALK rearrangement\u2014combination of EGFR tyrosine kinase inhibitors and ALK inhibitors. JTO Clin Res Rep 2022; 3(11): 100405.","journal-title":"JTO Clin Res Rep"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X261452412","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X261452412","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X261452412","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T07:19:57Z","timestamp":1779779997000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X261452412"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":15,"alternative-id":["10.1177\/2050313X261452412"],"URL":"https:\/\/doi.org\/10.1177\/2050313x261452412","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"article-number":"2050313X261452412"}}