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Case Report: Pulmonary enteric adenocarcinoma harboring KRAS/TP53/APC mutations with contralateral lung metastasis: diagnostic challenges and molecular insights

Year: 2026

Type: article

Abstract: Pulmonary enteric adenocarcinoma (PEAC) is a rare subtype of lung adenocarcinoma characterized by intestinal differentiation. We report a case of synchronous bilateral PEAC in an elderly male patient, a presentation that is rarely documented in the literature. Histopathological examination revealed glandular structures resembling colorectal adenocarcinoma, with immunohistochemical positivity for CDX2, CK20, and SATB2, and negativity for TTF-1 and CK7. Molecular testing identified concurrent KRAS, TP53, and APC mutations, suggesting the activation of a colorectal-like oncogenic pathway. Following surgical resection and adjuvant chemoradiotherapy, the patient achieved short-term disease stability. This case highlights the diagnostic dilemma between primary PEAC and metastatic colorectal cancer and underscores the importance of integrated molecular and immunophenotypic profiling for accurate classification and potential targeted therapy.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2025.1726695

Authors: Mengjie Mao, Mengling Hu, Qingxiu Tao, Zhuo Zuo, Bin Liu

Institutions: Chengdu University of Traditional Chinese Medicine, University of Electronic Science and Technology of China, Sichuan Cancer Hospital

Language: English

Topic: Metastasis and carcinoma case studies

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801