Abstract
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have demonstrated improved progression-free survival benefits and decreased treatment-related side effects, and therefore are now considered first-line of treatment of EGFR mutated, metastatic non-small cell lung carcinoma (NSCLC). Cryptococcal endocarditis is an extremely rare clinical entity with only seven reported cases in the literature. Prior cases were seen in patients with a history of rheumatic heart disease or prior valve replacement surgery. Little is known regarding the natural history and optimal management of Cryptococcal endocarditis, given the limited available data. We present a case of Cryptococcal endocarditis and meningitis in a patient with metastatic NSCLC receiving targeted therapy with an EGFR-TKI with no history of significant cardiac disease.
Highlights
Epidermal growth factor receptors (EGFR) are cell surface transmembrane receptors belonging to the epidermal growth factor (EGF) family of extracellular protein ligands and includes the ErbB1 and HER1 families
We present a case of Cryptococcal endocarditis and meningitis in a patient with metastatic non-small cell lung carcinoma (NSCLC) receiving targeted therapy with an EGFR-TKI with no history of significant cardiac disease
Several landmark studies over the past decade have demonstrated progression-free survival (PFS) benefit and decreased treatment-related severe side effects and death of EGFR TKIs when compared to standard chemotherapy for patients with metastatic NSCLC with sensitizing EGFR mutations [3,4,5,6,7,8]
Summary
Epidermal growth factor receptors (EGFR) are cell surface transmembrane receptors belonging to the epidermal growth factor (EGF) family of extracellular protein ligands and includes the ErbB1 and HER1 families. Several landmark studies over the past decade have demonstrated progression-free survival (PFS) benefit and decreased treatment-related severe side effects and death of EGFR TKIs when compared to standard chemotherapy for patients with metastatic NSCLC with sensitizing EGFR mutations [3,4,5,6,7,8]. The study included patients with stage IIIB or IV NSCLC and EGFR mutation who received no prior chemotherapy for metastatic disease. Journal of Clinical and Medical Case Reports doi:10.31487/j.JCMCR.2020.02.06 echogenic mass on the left-ventricular side of the non-coronary cusp of the aortic valve measuring 5.1 x 6.7 mm and a smaller mass on the right coronary cusp measuring 3.3 x 3.6 mm (Figure 2) During this admission, the patient was hemodynamically stable, afebrile, and had no leukocytosis. The risks were deemed to outweigh benefits of further lumbar puncture or valve replacement, and the patient and her family decided to transition to hospice care
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