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case_images: CT imaging changes before and after treatment. (A) Chest CT images on 23 July, 2019 showed T1 vertebral metastasis, (B) Chest CT images on 23 July, 2019 showed T6 vertebral metastasis, (C) Chest CT images showed osteogenic changes of T1 vertebral metastasis after radiotherapy, (D) Chest CT images showed osteogenic changes of T6 vertebral metastasis after radiotherapy.
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case_images: MRI and CT scans indicated metastases in the T1 and T6 vertebrae ( Figures 1A, B ). During regular follow-up examinations, the disease remained stable, with osteogenic changes observed in the thoracic vertebral metastases ( Figures 1C, D ).
case_images: MRI changes in leptomeningeal metastasis before and after treatment. (A-C) MRI images of leptomeningeal metastasis in September 2021 showing significant thickening and pronounced enhancement of the meninges in the cerebellum. (D-F) After three courses of intrathecal chemotherapy, the thickening and pronounced enhancement of the meninges in the cerebellum disappeared.
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case_images: Magnetic resonance imaging (MRI) revealed significant thickening and pronounced enhancement of the meninges in the cerebellum ( Figures 2A-C ). Following one course of intrathecal chemotherapy, the symptoms of dizziness and headache were alleviated, and after three courses of intrathecal chemotherapy, the thickening and pronounced enhancement of the meninges in the cerebellum disappeared ( Figures 2D-F ), and CSF cytology was negative ( Figure 3B ).
case_images: CSF cytology findings before and after treatment. (A) CSF cytology findings in September 2021 reveal tumor cells (HE staining,x100). (B) CSF cytology showing reactivity changes after three courses of intrathecal chemotherapy (HE staining,x100).
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case_images: A lumbar puncture confirmed the presence of cancer cells in the cerebral effusion, suggesting meningeal metastasis ( Figure 3A ). Following one course of intrathecal chemotherapy, the symptoms of dizziness and headache were alleviated, and after three courses of intrathecal chemotherapy, the thickening and pronounced enhancement of the meninges in the cerebellum disappeared ( Figures 2D-F ), and CSF cytology was negative ( Figure 3B ).
case_images: Timeline of the treatment process.
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case_images: Since the diagnosis of LM, the patient has survived for 28 months ( Figure 4 ).