PMC5880229_01
Break-apart fluorescence in situ hybridisation of the presented case.
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figure1
Color Breakapart DNA probe; Vysis , Abbott Park, IL, U.S.A) that revealed the presence of ALK rearrangement (Figure 1), leading to the initiation of crizotinib 250 mg twice daily. 13 months later, the patient presented with symptoms suggestive of absence crises. A brain magnetic resonance imaging (MRI) revealed brain lesions, suggestive of secondary brain metastases.
MRI in axial T1-weighted post contrast images demonstrates cystic lesions with ring enhancement in the baseline examination (A and B), delineating cystic areas and ill-defined nodular areas within it, with no surrounding oedema. There was a slight reduction of the lesions after 3 months of ceritinib (C and D), with signs of a more evident response after 6 months (E and F), with reduction of the cystic component of some lesions, and after 9 months (G and H), with reduction of the cystic components and the enhancement.
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figure2
The brain MRI and the chest CT showed partial response (PR) in both brain and systemic lesions (Figure 2).