PMC9168597_01
Chest CT of the patient before treatment: (A-D) show the range of lesions, respectively.
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Contrast-enhanced computed tomography (CT) of the chest showed mass in the lower lobe of the left lung and the right lower lung, which suggested that lung cancer might be considered (Figures 1A-D). According to the abnormal signals in the left frontal lobe and cerebellar hemispheres shown by brain enhancement magnetic resonance (MR) (Figures 6A1, B1), the possibility of metastases was considered to be high.
Results of the first puncture: (A) Microphotographs of small cell lung cancer; (B-I) thymic carcinoma with immunohistochemistry for CD56, CK, Syn, LCA, Ki67, P40, TTF-1, CgA.
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On April 9, 2019, a lymph node biopsy was performed under ultrasound guidance, and the pathologic results showed small cell lung cancer (SCLC) (Figures 2A-I). A month later, we rechecked the brain enhancement MR (Figures 6A2, B2) and found that the lesions did not shrink and there were new lesions.
The lesions on positron emission tomography/computed tomography (PET/CT).
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Later, on April 15, 2019, positron emission tomography/computed tomography (PET/CT) showed positive lesions in the right lower lobe, mediastinal soft tissue, left lower lobe, bilateral hilum, and other sites (Figure 3).
The efficacy was evaluated as partial response (PR): (a1, b1) were before treatment, (a2, b2) were after 2 cycles of treatment.
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April 2019 to May 2019, the patient received 2 cycles of EP chemotherapy regimen with etoposide 100 mg/m2 on days 1-3 and cisplatin 25 mg/m2 on days 1-3 in each 3-week period. After 2 cycles of chemotherapy, the efficacy was evaluated as partial response (PR) (Figure 4).
Result of the second puncture: lung adenocarcinoma.
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The pathology showed a low differentiated carcinoma, consistent with adenocarcinoma, with the possibility of complex carcinoma (Figure 5).
(A1, B1) are before treatment of alectinib, (A2, B2) are after treatment of alectinib.
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According to the abnormal signals in the left frontal lobe and cerebellar hemispheres shown by brain enhancement magnetic resonance (MR) (Figures 6A1, B1), the possibility of metastases was considered to be high. A month later, we rechecked the brain enhancement MR (Figures 6A2, B2) and found that the lesions did not shrink and there were new lesions.