PMC4698998_01
Before starting pazopanib a cerebellar lesion of 6 mm in diameter appeared and left adrenal gland solid nodule was 4 cm in size, with a little necrotic core.
CRIONM2015-629046.001.jpg
PMC4698998_01_CRIONM2015-629046.001.jpg
fig1
The treatment was stopped after just 4 months because of the fact that CT scan had showed a new cerebellar lesion of 6 mm in the right side and a further progression of the left adrenal nodule (4 cm) (Figure 1).
After 3 cycles of pazopanib the adrenal metastasis was stable in dimension but with more necrotic area.
CRIONM2015-629046.002.jpg
PMC4698998_01_CRIONM2015-629046.002.jpg
fig2
The tolerance to SRS was good and the third-line therapy with the TKI, pazopanib (800 mg per day), was started in February 2012. The first CT evaluation showed SD in both cerebellum and adrenal glands, although the left adrenal nodule had become necrotic (Figure 2).
After 12 cycles of pazopanib there was a 30% reduction.
CRIONM2015-629046.003.jpg
PMC4698998_01_CRIONM2015-629046.003.jpg
fig3
After twelve cycles, 30% reduction of the left adrenal metastasis was observed (Figure 3) with further reduction of 10% in July 2013.