━━ Background. EGFR mutations are rarer in squamous cell carcinoma than in adenocarcinoma. The efficacy of osimertinib in treating squamous cell carcinoma with EGFR mutations has therefore not yet been investigated. Cases. (1) A 72-year-old man was diagnosed with postoperative recurrence of lung adenocarcinoma (pT2N2M0, stage IIIA, exon19 del). A biopsy was performed after treatment with afatinib and erlotinib. Simultaneously, squamous cell lung carcinoma manifestation and a T790M mutation were observed. Even after osimertinib administration for two months, the condition of the patient worsened. (2) A 70-year-old woman was diagnosed with squamous cell lung carcinoma (cT3N3M1c, stage IVB, L858R). After osimertinib administration for one month, brain metastasis worsened. Since the primary tumor shrank, whole-brain irradiation was performed, and osimertinib was continued. After three months, the primary tumor also worsened. Conclusion. These findings suggest that the efficacy of osimertinib for squamous cell lung carcinoma might be poor in some cases.

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A 59-year-old man presented with esophageal achalasia complicated by lipoid pneumonia. Dysphagia and diffuse ground-glass shadows on computed tomography led to the diagnosis of esophageal achalasia. An analysis of bronchoalveolar lavage (BAL) revealed yellow BAL fluid, with two distinct layers. Oil droplets were observed in the upper layer. Macrophages that phagocytosed lipids were also observed. He was diagnosed with lipoid pneumonia secondary to esophageal achalasia. His lipoid pneumonia improved after peroral endoscopic myotomy because of the reduction in aspiration risk.

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