Subdural Hematoma During Lorlatinib-Induced Regression of Leptomeningeal Carcinomatosis with Suspected Dural Involvement in ALK-Positive Lung Adenocarcinoma
Abstract
Lorlatinib, a central nervous system (CNS)-penetrant anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor, is effective in treating leptomeningeal carcinomatosis. A woman in her 30s with ALK-positive lung adenocarcinoma and leptomeningeal carcinomatosis developed an asymptomatic subdural hematoma (SDH) 7 weeks after starting lorlatinib, coinciding with the regression of leptomeningeal lesions. The posterior extent of the SDH appeared to be partially contiguous with the focal dural enhancement observed before treatment. Lorlatinib was continued under multidisciplinary supervision. The hematoma resolved without surgery and did not recur during the 6 years of treatment. SDH may occur during the rapid regression of leptomeningeal disease with suspected dural involvement under CNS-penetrant ALK inhibitor therapy.
Related
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BibTeX
@article{kakefuda2026subdural,
title = {{Subdural Hematoma During Lorlatinib-Induced Regression of Leptomeningeal Carcinomatosis with Suspected Dural Involvement in ALK-Positive Lung Adenocarcinoma}},
author = {Taiyo Kakefuda and Katsuyoshi Tomomatsu and Kaiki Suzuki and Kohei Umemoto and Yukihiro Horio and Jun Nishiyama and Naoki Hayama and Yoko Ito and Koichiro Asano and Tsuyoshi Oguma},
journal = {Internal Medicine},
year = {2026},
month = oct,
doi = {10.2169/internalmedicine.8083-26},
url = {https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8083-26/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Subdural Hematoma During Lorlatinib-Induced Regression of Leptomeningeal Carcinomatosis with Suspected Dural Involvement in ALK-Positive Lung Adenocarcinoma
AU - Taiyo Kakefuda
AU - Katsuyoshi Tomomatsu
AU - Kaiki Suzuki
AU - Kohei Umemoto
AU - Yukihiro Horio
AU - Jun Nishiyama
AU - Naoki Hayama
AU - Yoko Ito
AU - Koichiro Asano
AU - Tsuyoshi Oguma
PY - 2026
DA - 2026/10/08
JO - Internal Medicine
DO - 10.2169/internalmedicine.8083-26
UR - https://www.jstage.jst.go.jp/article/internalmedicine/advpub/0/advpub_8083-26/_article
AB - Lorlatinib, a central nervous system (CNS)-penetrant anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitor, is effective in treating leptomeningeal carcinomatosis. A woman in her 30s with ALK-positive lung adenocarcinoma and leptomeningeal carcinomatosis developed an asymptomatic subdural hematoma (SDH) 7 weeks after starting lorlatinib, coinciding with the regression of leptomeningeal lesions. The posterior extent of the SDH appeared to be partially contiguous with the focal dural enhancement observed before treatment. Lorlatinib was continued under multidisciplinary supervision. The hematoma resolved without surgery and did not recur during the 6 years of treatment. SDH may occur during the rapid regression of leptomeningeal disease with suspected dural involvement under CNS-penetrant ALK inhibitor therapy.
SN - 1349-7235
SN - 0918-2918
ER -