PMC4973714_01
Computed tomography images of the chest of a patient with multiple lung metastases from renal leiomyosarcoma.. Notes: (A) Before sunitinib malate treatment; (B) 4 weeks after sunitinib malate treatment (37.5 mg/d); (C) 1 month after withdrawal of sunitinib malate due to severe adverse effects; (D) after resuming use of sunitinib malate at the dose of 25 mg/d; (E) 26 months after sunitinib malate treatment. Arrows indicate sites of lesions.
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The chest CT scan on April 15, 2009 showed multiple pulmonary nodular lesions, and the patient was finally diagnosed with multiple lung metastases from renal leiomyosarcoma (Figure 1). A chest CT scan 4 weeks later indicated a stable disease (SD) status with some lung lesions presenting vacuoles, according to the Response Evaluation Criteria in Solid Tumors (RECIST) (Figure 1B). August 2012). A chest CT scan on August 21, 2012 revealed progressive disease due to the withdrawal of sunitinib malate (Figure 1C). However, the patient was restored to a SD status just 1 month after she resumed sunitinib treatment (Figure 1D), indicating that sunitinib malate was still effective for the control of multiple lung metastases. As of March 15, 2014, the patient has continually taken oral sunitinib malate for 26 months, and chest CT scans have indicated no progression of disease (Figure 1E).
Adverse effects of sunitinib malate included hand-foot syndrome (grade 3).. Notes: (A) hand; (B) foot.
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Toxic adverse effects of sunitinib malate, based on the Common Terminology Criteria for Adverse Events v3.0, were observed in this patient, including fatigue (grade 2), hand-foot syndrome (grade 3) (Figure 2A and B), and stomatitis (grade 2).