PMC3239171_01
Serum CEA in relation to start of treatments.
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Her epithelial markers were elevated (Figure 1 summarizes the time course of CEA, and not shown, also paralleled by CA27.29).Anti-estrogen therapy (tamoxifen) was begun, with accompanying low-dose aspirin (later discontinued) to minimize the risk of thromboembolic disease. Brief response to exemestane withdrawal (2008) The patient's CEA level dropped over 2 consecutive months (Figure 1) after exemestane withdrawal to 9.2 ng/ml (1/14/08), 5.6 ng/ml (2/19/08) and 8.6 ng/ml (3/10/08).
Abdominal cross-section showing left adrenal mass and FDG uptake (upper panel). See text for time points.
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She experienced improvement until February 2008 when routine labs showed increasing CEA and increased 18fluorodeoxyglucose (FDG) uptake on PET/CT was noted in the left adrenal (Figure 2, cross section) and in lung and mediastinum (Figure 3, cross section). However, CEA increased to above 13 ng/ml (3/31/08), when an MRI in May 2008 noted decreased disease in the chest but a larger left adrenal mass (Figures 2 and 3).
Thoracic cross-section showing right lung infiltrate and FDG uptake (upper panel). See text for time points.
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She experienced improvement until February 2008 when routine labs showed increasing CEA and increased 18fluorodeoxyglucose (FDG) uptake on PET/CT was noted in the left adrenal (Figure 2, cross section) and in lung and mediastinum (Figure 3, cross section). However, CEA increased to above 13 ng/ml (3/31/08), when an MRI in May 2008 noted decreased disease in the chest but a larger left adrenal mass (Figures 2 and 3).
PMC3239171_02