PMC9045700_01
Ultrasonography features of the case. Ultrasonic images showed a 1.5 * 0.9CM hypoechoic nodule in the left supraclavicular area, with abundant blood flow signals, which indicated cancer metastatic lymph nodes.
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In June 2020, after a disease-free interval of about 7 years, during the course of follow-up, a 57-year-old patient was first found with supraclavicular adenopathy by ultrasonography (Figure 1), and computed tomography (CT) scan showed a 1.2 * 0.9-cm lymph node apparently strengthened with contrast (Figure 2).
Neck computed tomography (CT) scan findings. Pretreatment axial neck computed tomography (CT) slice taken in the region of supraclavicular fossa revealed a 1.2 * 0.9-cm soft tissue mass in nodal level V.
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In June 2020, after a disease-free interval of about 7 years, during the course of follow-up, a 57-year-old patient was first found with supraclavicular adenopathy by ultrasonography (Figure 1), and computed tomography (CT) scan showed a 1.2 * 0.9-cm lymph node apparently strengthened with contrast (Figure 2).
Dose distribution of the treatment plan using 3-dimensional conformal radiation therapy. The dose distribution of the reirradiation plan (30 F x 2 Gy) with 3-dimensional conformal radiation therapy.
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The scheduled radiation dose was 60 Gy in 30 fractions with 6-MV X-ray delivered by 3-dimensional conformal radiation therapy (3D-CRT) conducted to the primary tumor volume (Figure 3).
The response of the targeted lymph node to the concomitant fulvestrant with reirradiation. CT scan monitored the continuous response of the breast cancer metastatic neck lymph node during the follow up. (A) CT simulation image prior to the first treatment; (B) CT scan image at end of the 25th fraction of reirradiation; (C) follow-up CT scan at 1 month after the end of reirradiation therapy; (D) follow-up CT scan at 3 months after reirradiation therapy; (E) follow-up CT at 7 months after reirradiation therapy; (F) follow-up CT at 10 months after reirradiation therapy.
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At the end of the radiotherapy, CT scan showed a continuously radiologic response of the metastatic lymph node (RECIST 1.1) (Figure 4).