PMC8450156_01
Timeline of the clinical course. Thoracic CT images of the tumor at baseline (A), after neoadjuvant treatment with gefitinib (C and D), and at postoperative follow-up (G and H); Hematoxylin-Eosin stained slide of the core needle biopsy (B), resected primary lesion (E) and resected lymph node (F).
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Computed tomography (CT) revealed a 4.3*3.5 cm lung mass and a suspicious 7 mm solitary metastasis in the right lower lobe, as well as enlarged hilar and mediastinal lymph nodes (group 2R, 4R, 6, 7, 10R) (Figure 1A). Biopsy of the lung mass confirmed a pure keratinizing squamous cell carcinoma which was negative for EML4-ALK fusion (Figure 1B). The tumor rapidly shrank down (Figure 1C) and nearly disappeared after 11 weeks of treatment with normal serum level of tumor markers (Figure 1D). The short-axis diameter of the largest lymph node (4R) decreased from 1.4 cm to 0.8 cm. Pathological examination found no residual tumor cell in both primary lesion (Figure 1E) and draining lymph nodes (Figure 1F). She remains disease-free and is on active follow-up as of the writing of this report (Figure 1G and H).