PMC4459626_01
The computed tomography scan at diagnosis with a 3.9 cm bean-shaped tumor in the upper lobe of right lung (A). The lesion had significant reduction in tumor size 1 month later (B), and remained stable for 31 months with oral icotinib therapy (C).
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She was found to have stage IV adenocarcinoma (T2N2M1, Figures 1 and 2) with multiple bone and brain metastases. A partial response (PR) was seen after 1 month icotinib treatment (Figure 1 B), and this PR persisted for 31 months (November 16, 2014) during which the Eastern Cooperative Oncology Group PS of the patient remained 1.
Stained sample of bone metastasis of lung adenocarcinoma, original magnification x400.
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She was found to have stage IV adenocarcinoma (T2N2M1, Figures 1 and 2) with multiple bone and brain metastases.
Computed tomography (CT) and magnetic resonance imaging scan of spine.. Notes: T8 and T10 pathological fracture with local spinal canal stenosis (A, B). CT scan after surgery via retroperitoneal approach and radioactive particle implantation into T8 and T10 spine (C, D).
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Computed tomography (CT) scan revealed an osteolytic lesion 11 cm in size in the left scapula, magnetic resonance imaging (MRI) revealed pathological fracture and spinal canal stenosis at T8 and T10 thoracic vertebrae (Figure 3), and small nodules on the cerebellum and bilateral temporal lobe (Figure 4). Given the fracture, the high risk of paraplegia due to spinal cord compression, good bodily functions with no medical comorbidities, and the positive EGFR mutation, an internal fixation between T7 and T11 via retroperitoneal approach combined with an implantation of radioactive particle into T8 and T10 spine (Figure 3 C,D) was performed.
MRI scan of brain (scattered small nodules on the cerebellum and bilateral temporal lobe).. Notes: The lesions remained stable at diagnosis (A), 1 month (B), and 31 months later (C). R=right side.
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Computed tomography (CT) scan revealed an osteolytic lesion 11 cm in size in the left scapula, magnetic resonance imaging (MRI) revealed pathological fracture and spinal canal stenosis at T8 and T10 thoracic vertebrae (Figure 3), and small nodules on the cerebellum and bilateral temporal lobe (Figure 4).
ECT scan at diagnosis (A) and after 31 months icotinib treatment (B).. Note: The arrow shows higher radioactive concentration on right iliac bone in B than A.. Abbreviation: ECT, electrical capacitance tomography.
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The ECT scans revealed higher radioactive concentration on right iliac bone (Figure 5) without other progression according to systematic examination.