PMC7240179_01
CT showed a lung nodule before CIRT (A). Radiation isodose distribution of CIRT (B). One year after CIRT, the left lung nodule had decreased in size (C). Three years after CIRT, the original lesion is undetectable (D). Four years after CIRT a new nodule has appeared (E) and has increased in size one year later (F).
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The nodule was 15 mm in diameter (Fig. 1A). Five years previously he had refused surgery for lung cancer and undergone CIRT at 52.8 Gy equivalents in four fractions (Fig. 1B). Lung nodule had resolved completely, having been decreased in size 1 year after CIRT (Fig. 1C) and undetectabIle 3 years after CIRT (Fig. 1D). Four years later, chest computed tomography (CT) showed a 20-mm nodule (Fig. 1E) and he was referred to our hospital for treatment (Fig. 1F). 18F-Fluorodeoxyglucose-positron emission tomography revealed FDG uptake in the lung nodule with a maximum standardized uptake value of 2.6.
Hematoxylin and eosin stain in tumor tissue (original magnification x 20). Photomicrographs showing squamous cell carcinoma (A) in an area of scarring with remarkable fibrosis (B).
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Pathological examination showed tumor cells (Fig. 2A) in scar tissue (Fig. 2B) with remarkable fibrosis and squamous cell carcinoma was confirmed.