PMC9035951_01
a Contrast-enhanced computed tomography images showing a mass lesion in the upper pole of right kidney protruding toward the perirenal fat, which was later diagnosed pathologically as crizotinib-associated renal cysts (CARCs). b CARC-like aseptic abscesses along the abdominal wall near the surgical wound appeared after the readministration of crizotinib. The figure also shows similar lesions remaining in the resected right kidney.
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F1
CT 12 months after crizotinib initiation revealed a mass in the upper pole of the right kidney protruding toward perirenal fat (shown in Fig. 1a). C-reactive protein, with subsequent CT showing abscess-like inflammation in the abdominal wall near the surgical wound and around right kidney (shown in Fig. 1b). Considering that antibiotic administration (cefaclor) had no effect, crizotinib was stopped and surgical cleaning was performed.
a Macroscopic findings of the surgical specimen following right partial nephrectomy showing a yellowish-brown mass with fibrosis and cystic degeneration involving perirenal fat. b High-power field image with hematoxylin-eosin staining showing xanthogranulomatous inflammation characterized by infiltration of lipid-laden macrophages and other inflammatory cells, fibrosis with hyalinization, and hemosiderin deposition. Scale bar, 20 mum.
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F2
Pathology revealed xanthogranulomatous inflammation characterized by infiltration of lipid-laden macrophages and other inflammatory cells, fibrosis with hyalinization, and vasculation without malignancy or microbes (shown in Fig. 2a, b), which was consistent with CARCs.
a Enhanced computed tomography images obtained 26 days before the emergency hospitalization, from which brain metastases were not detected. b Enhanced magnetic resonance images on the emergency hospitalization showing a "disease flare" of brain metastases with brain edema. c Image of the same lesions obtained 14 days after entrectinib initiation, which regressed remarkably.
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F3
Enhanced magnetic resonance imaging revealed multiple brain metastases with edema which were not detected from the CT images obtained 26 days before admission (Fig. 3a, b). Hemiparesis improved, with subsequent magnetic resonance imaging on day 14 of entrectinib administration, showing a remarkable regression of the brain metastases with surrounding brain edema (shown in Fig. 3c).