PMC9968780_01
The treatment history of this patient. (A) Computed tomography (CT) from initial diagnosis on May 24, 2018 (Right lung: 52x31 mm). The red arrow indicates the tumors. (B) Hematoxylin-eosin staining of right lung (400 X). (C) Laboratory examinations of serum tumor marker. (D) CT images of new lesion in left lung on May 7, 2021 (Left lung: 22.0x17.0 mm; Right lung: 9.0x6.0 mm). The red arrow indicates the tumors. (E) Rebiopsy samples after chemotherapy resistance showed transformation to LUSC (400 X). (F) CT images of post PD-1 inhibition treatment on December 22, 2021 (Left lung: 18.0x16.8 mm; Right lung: 5.9x5.1 mm) and (G) recent re-examination on February 21, 2022 (Left lung: 34.0x20.0 mm; Right lung: 6.8x5.6 mm). The red arrow indicates the tumors. (H) Timeline of the clinical course in this patient.
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A computed tomography (CT) scan of the chest revealed a soft tissue mass of 52.0x31.0 mm in the right lower lobe, multiple pulmonary nodules, and enlarged mediastinal lymph nodes (Figure 1A). A CT-guided tumor biopsy was then performed, and the tumor was pathologically diagnosed as ES-SCLC of right lung (Figure 1B). CA125, CA242, alpha-fetoprotein (AFP) and neuron-specific enolase (NSE, Figure 1C). Cisplatin combined with etoposide was subsequently given. Until May 7, 2021, a new lesion appeared in the left lung (22.0x17.0 mm, Figure 1D). The biopsy of left lung identified lung squamous cell carcinoma (LUSC) (Figure 1E).  After eight cycles treatment, the tumor lesion in the right lung significantly decreased (5.9x5.1 mm) and left lung remained stable (18.0x16.8 mm) (Figure 1F). February 21, 2022, the patient was re-examined, and CT showed slight enlargement of the right lung lesion (6.8x5.6 mm), but significant enlargement of the lung lesion on the left (34.0x20.0 mm), suggesting PD (Figure 1G and H). Finally, the PFS was 9.7 months.