case_images: PMC5361706_01
case_images: Fluorodeoxyglucose positron emission tomography (FDG-PET) performed in different times are shown: a FDG-PET performed in March 2013 (before trametinib treatment); b FDG-PET performed in May 2015 after 20 months of trametinib treatment
case_images: 40164_2017_67_Fig1_HTML.jpg
case_images: PMC5361706_01_40164_2017_67_Fig1_HTML.jpg
case_images: Fig1
case_images: A computed tomography (CT) scan with contrast showed right axillary lymph node metastases and liver lesions, and a full-body fluorodexoyglucose positron emission tomography (FDG-PET) scan confirmed the presence of metastases in the right axillary lymph node and hepatic segment V; metastases in left axillary, rear left scapular, right retroperitoneal, skeletal D8-D9, and vertebral L1 regions were also observed (Fig. 1a). 
case_images: Computed tomography (CT) scan performed during trametinib treatment: images showing right axillary lymphadenopathy, liver metastasis, right hilar lymphadenopathy, T7 vertebral body metastasis and subcutaneous node are shown
case_images: 40164_2017_67_Fig2_HTML.jpg
case_images: PMC5361706_01_40164_2017_67_Fig2_HTML.jpg
case_images: Fig2
case_images: The previous lesions were confirmed, and the scan additionally revealed an increased number of lymphadenopathies in the right axillary region (maximum diameter 65 mm), a millimetric lesion in the right hepatic lobe, two new metastatic lesions in the precharinal and right lung ilus (maximum diameter 16 mm), and new bone metastases in the left rib IX and right acetabulum (Fig. 2a).  Subsequent CT scans (performed every 3-4 months) showed maintenance of complete response in all known lesions, with the exception of the increasing lymphadenopathy in the right axilla (Fig. 2c). In December 2015, a new CT scan confirmed complete response, with no evaluable lesions (Fig. 2d).