PMC7719342_01
Pituitary MRI (sagittal plane) in the three patients reported in this study. In case 1, (A) the bright-spot of posterior pituitary on T1WI was absent and (B) recurred after 3-month dabrafenib treatment (white arrowheads). In case 2, (C) the bright-spot of posterior pituitary was absent and (D) recurred after 1-month dabrafenib treatment (white arrowheads). In case 3, (E) decreased bright-spot of posterior pituitary on T1WI (white arrowhead) and infundibular thickening (red arrowhead) were observed. (F) After 1-month dabrafenib combined with trametinib treatment, the brightness was higher (white arrowhead) with recovered infundibulum (red arrowhead).
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Because of a poor response to first-line chemotherapy (for 13 weeks) on his pituitary imaging (an absence of the normal posterior pituitary bright spot, Figure 1A; the other lesions were in a stable state), dabrafenib treatment was initiated at the age of 3.6, two weeks after completing the chemotherapy. After 3 months of dabrafenib treatment, the bright spot on the posterior pituitary on T1WI recurred with a higher signal intensity ratio compared with the gray matter (Figure 1B), and the other lesions also improved. Because of a poor response to first-line chemotherapy (for 5 weeks) on pituitary imaging (an absence of the normal posterior pituitary bright spot, Figure 1C; the other lesions were in AD-better state), dabrafenib treatment was administered two weeks after completion of his chemotherapy. The brightness of the posterior pituitary on T1WI recovered after 1 month of dabrafenib treatment (Figure 1D). At the end of the observation, the boy had taken combination targeted treatment for 10 months and did not experience DI in an AD-better state with clearer bright spots on the posterior pituitary on T1WI and had a recovered infundibulum (Figure 1F).