PMC7461970_01
The 68Ga-PET/CT shows areas of slight somatostatin receptor uptake in the right subpleural paracardiac area, standardized uptake value (SUVmax = 5.2), and some pre-vascular (SUVmax = 2.3), retrosternal (SUVmax = 3.2), Barety lodge (SUVmax = 3), and right peribronchial (SUVmax = 5.4) node uptake (red arrows). Some areas in the dorsal segment of the upper lobe of the right lung and in middle lobe of the right lung showed no uptake. Slight uptake of the radiopharmaceutical product in the sternal body (SUVmax = 5.9) and the VI and VII right ribs (SUVmax = 8.6) (blue arrows).
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F1
After a multidisciplinary discussion, it was decided to perform a 68-Gallium (68Ga)-DOTATOC-PET/CT, which showed very slight somatostatin receptor uptake by both the primary and metastatic lesions (Figure 1).
CT imaging of selected target lesions at baseline (A) and during treatment (B). Representative axial CT images of patient shows a slight reduction in size of the primitive tumour, 35 mm (B1) vs. 40 mm (A1) (blue arrows) and pleural localizations on the left side 16 mm (B2) vs. 20 mm (A2) (yellow arrows), and right side 22 mm (B3) vs. 26 mm (A3) (red arrows).
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F2
The patient underwent 18 courses of three-weekly pembrolizumab, obtaining stable disease for more than 1 year (Figure 2).
Timeline showing patient history from the diagnosis of Squamous Cell Thymic Cancer to the most recent treatment perspectives.
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F3
It was decided to stop pembrolizumab and after a multidisciplinary discussion the patient started treatment with sunitinib (Figure 3).