Primary Lung Adenocarcinoma in Pregnancy: A Case Report

Case Report: This is a unique case of metastatic primary lung adenocarcinoma diagnosed in a 25-year-old G3P2002 at 15 weeks of gestation. The patient presented with acute onset of left chest and shoulder pain. Evaluation revealed anaplastic lymphoma kinase (ALK) positive, primary lung adenocarcinoma with metastasis to the liver and right adrenal gland. Treatment with palliative Alectinib 450 mg twice daily was initiated at 18 weeks gestation and increased to Alectinib 600 mg twice daily at 27 weeks gestation. Uncomplicated delivery occurred via spontaneous vaginal delivery following scheduled induction at 39 weeks and 2 days. There are few cases of lung cancer in pregnancy, and none which describe delivery at term in a patient with metastatic disease. This case provides insight on the treatment of ALK positive metastatic lung cancer during the second and third trimesters of pregnancy without necessitating preterm delivery or cesarean section.