PMC9097915_01
Baseline CT scan (16/December/2016).
fonc-12-838114-g001.jpg
PMC9097915_01_fonc-12-838114-g001.jpg
f1
A chest and abdominal computed tomography (CT) scan revealed a large left retroperitoneal mass measuring 83 x 68 mm (Figure 1), with central necrosis.
VMAT-IGRT for cardiac progression (CRO Aviano, Italy).
fonc-12-838114-g002.jpg
PMC9097915_01_fonc-12-838114-g002.jpg
f2
Between May and June 2020, the patient received VMAT-IGRT (Volumetric Modulated Arc Therapy - Imaging Guided Radiation Therapy) to the ventricular lesion with 44Gy in 22 fractions to Planning Target Volume (PTV) plus simultaneous integrated boost to Gross Tumor Volume (GTV) at the dose of 55 Gy (Figure 2).
Comparison between February 2020 (on the left) and July 2020 (on the right): CT stability of cardiac mass and pulmonary and renal partial response.
fonc-12-838114-g003.jpg
PMC9097915_01_fonc-12-838114-g003.jpg
f3
A new restaging CT, performed in July 2020, showed pulmonary and renal partial response and no change of the cardiac mass (Figure 3).
Comparison between September 2020 (on the left, pre-RT) and January 2021 (on the right, post-RT).
fonc-12-838114-g004.jpg
PMC9097915_01_fonc-12-838114-g004.jpg
f4
The CT performed in January 2021 showed stability of the cardiac mass (20 mm) and a partial response in the irradiated pulmonary (17 Vs 26 mm), pancreatic (14 Vs 20 mm) and renal (14 Vs 17 mm) lesions (Figure 4), and the patient continued treatment with pazopanib, with the disease stable at the next restaging CT scan in June 2021.