PMC7322342_01
Chest CT showed a tumor mass measuring 90 x 80 mm in the left lower lung with metastasis to the sternum, right rib, and both supraclavicular lymph nodes (A, B; arrows). Abdominal CT showed metastatic bilateral adrenal glands and peritoneal lesions (C, D; arrows).
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Contrast-enhanced chest computed tomography (CT) revealed a giant mass lesion in the left lower lung field and multiple bone metastases (Fig. 1A and B). Abdominal CT revealed bilateral adrenal gland metastases and peritoneal tumor disseminations (Fig. 1C and D).
A cytological specimen obtained by a transcutaneous needle biopsy at the sternum showed atypical epithelial cells with eccentric nuclei and intracytoplasmic (ICL) cells (arrow), which led to the diagnosis of adenocarcinoma (A: Papanicolaou staining, original magnification x 200, B: Giemsa staining, original magnification x 200.).
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The primary lung tumor markedly shrunk after the introduction of chemotherapy as demonstrated on serial CT images; on admission (A), 10 days after the introduction of chemotherapy (B), 70 days (C), and 140 days (D).
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A shrinkage in both the primary lung lesion and multiple metastases was observed upon resolution of the electrolytic disorder (Fig. 4).