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We report a 90-year-old woman who had complained of bloody sputum and for whom a chest CT showed a nodular lesion on the right lower lobe. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) was performed and adenocarcinoma was revealed in both a subcarinal lymph node (#7) and in the primary lung tumor. Epidermal growth factor receptor (EGFR) gene mutation status was evaluated, and an exon 21 point mutation (L858R) was identified by direct sequencing. Two weeks after administration of gefitinib, the tumor size decreased and bloody sputum disappeared. The patient has remained in good condition for 6 months.

Successful Treatment of Lung Cancer with Gefitinib and EGFR Mutation Status Determination Using EBUS-TBNA Samples in an Extremely Old Patient