Pulmonary adenocarcinoma was diagnosed from the malignant effusion. In stage IV disease, amplicon-based NGS diagnostics revealed a MET p.Y1021H...Crizotinib treatment was approved and initiated 8 weeks after histological diagnosis. Within the first week of therapy, the volume of pleural effusion decreased, and after 3 weeks no more catheter pleurocenteses were required. In parallel, the patient required no more analgesics and his overall performance improved dramatically. A CT scan obtained after 10 weeks of crizotinib confirmed objective response of the primary tumor and the metastatic pleural nodules. CT scans at 4 and 8 months and an FDG PET-CT scan at 6 months confirmed stable disease and metabolic response.