PMC7533245_01
Hematoxylin-eosin (HE) staining for pathological diagnosis in (A) right and (B) left pulmonary lesions showing lung adenocarcinoma.
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A 71-year-old non-smoker Chinese female was diagnosed with lung adenocarcinoma with multiple metastases in bilateral lung and mass in the right chest with osteolytic bone destruction in the sixth rib in May 2019 (Figure 1).
Molecular analysis of gene detection. The integrative genomics viewer snapshot of EGFR N771delinsKG (c.2312_2313insGGG) by next-generation sequencing (NGS).
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The sequencing results in Figure 2 suggested that the patient had a novel EGFR ex20ins (N771delinsKG) mutation.
Computed tomography (CT) scans at different time. (A) Baseline imaging (before treatment) of right and left pulmonary lesions, respectively. After (B) 1 month (July 28, 2019) and (C) 4 months (November 6, 2019) of treatment, the mass in the left pulmonary lesion reduced significantly and the right pulmonary lesion decreased slightly, compared with that of baseline imaging.
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Before the treatment, the computed tomography (CT) scans indicated that the size of tumor lesions located in the left lower lung and right chest were 62.6 mmx60.9 mm and 58.3 mmx46.7 mm, respectively (Figure 3A). After one month of afatinib treatment, the size of the lesion in the left lower lung reduced markedly and that of the tumor lesion in the right lung was stable (Figure 3B). As shown in Figure 3C, one lesion in the left lower lung became obscure and unmeasurable, and the size of another lesion in the right chest was decreased to 43.7 mmx37.2 mm.