PMC7567027_01
Review of treatment process (from March 2018 to May 2020). Treatment process and effect evaluation of the patient. PFS, progression-free survival; TFP, docetaxel, fluorouracil, cisplatin; T, docetaxel; GP, gemcitabine/cisplatin; PR, partial response; SD, stable disease; PD, progressive disease; mo, months.
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F1
Figure 1 illustrates the complete treatment procedure and the corresponding changes in the lesions on CT.
(A) Cytological features of fine-needle aspiration biopsy of the right parotid mass: few poorly differentiated carcinomas with necrosis (x20 hematoxylin/eosin). (B) Histopathological features of CT-guided lung mass biopsy: cancer cells in the lung tissue grow invasively, with local necrosis (x20 hematoxylin/eosin) (C) Androgen receptor (AR) (+,40%) (x20 hematoxylin/eosin) (D) The human epidermal growth factor receptor-2(HER2) demonstrated 3+ reactivity to show positive (x20 hematoxylin/eosin) (E) NapsinA: cancer cells were negative, while remaining alveolar epithelial cells were positive (x20 hematoxylin/eosin) (F) TTF1: cancer cells were negative, while remaining alveolar epithelial cells were positive (x20 hematoxylin/eosin).
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F2
HE staining combined with IHC of the biopsy tissues (Figure 2; positive for AR [40%], HER2 [3+], Ki-67 [80%], CK5/6, and EGFR, but negative for ER, PR, S-100, CD117, P53, TTF, and napsinA) confirmed that the parotid adenocarcinoma had metastasized to the lung.
CT scans show: (A) The first time of pulmonary metastasis; (B) after chemotherapy treatment; (C) CT of the chest showed a complete response after months of pyrotinib treatment.
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F3
CT scans performed after 3 months of treatment showed that the target pulmonary metastatic lesions completely disappeared, and the remaining lesions were significantly reduced, indicating a PR with a >30% decrease in the sum of the diameter compared with the previous examinations (Figure 3).