PMC9486213_01
Computed tomography (CT) scans. (A) 3D image of gingival tumor. (B) Lymph node metastasis area. (C) Lung metastases lesion. The red arrow indicates the location of the lesion.
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Computed tomography (CT) scan revealed an oval-shaped mass in the left lower gingival area with adjacent mandibular bone destruction and multiple enlarged lymph nodes in the neck and left submandibular area, and an occupying lesion in the upper lobe of the right lung ( Figure 1 ).
The hematoxylin-eosin (H&E) and immunohistochemical pictures of the tumor. (A) H&E, original magnification, x100. (B) H&E, original magnification, x400. Immunohistochemistry: CKpan (C), Vementin (D), EMA (E), P63 (F), and S100 (G).
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Immunohistochemistry ( Figure 2 ) outcomes were presented as follows: AE1/AE3 (+), P63 (+), EMA (+), CKpan (+), Vimentin (+), Ki67 (80%), EGFR (70%), S100 (-), CK5/6 (-), P40 (-), CK7 (-), and PD-L1 (DAKO 22C3) (CPS: 50).
CT imaging of changes of gingival masses. (A) RT dose distribution image. (B) Before CRT (62 mmx53 mmx64 mm). (C) CRT and crizotinib for 1 week (50 mmx32 mmx42 mm). (D) Adjust the radiotherapy area (gingival mass: 8mmx27mmx46mm). (E) CRT and crizotinib for 1 month (undetectable tumor size). (F) Oral crizotinib for 2 months (efficacy evaluation as CR).
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The plan was reevaluation to ensure a high dose in the tumor site ( Figure 3 ).