case_images: PMC11324500_01
case_images: Radiographic evidence of hyperprogression after ICI of the first case. Pre-treatment with ICI, CT scan: (A) brain; (C) chest and (E) vertebral column. Post treatment with ICI, CT scan that showed disease progression in the same sites: (B) brain, (D) chest and (F) vertebral column.
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case_images: PMC11324500_01_fonc-14-1437325-g001.jpg
case_images: f1
case_images: The American Joint Committee on Cancer (AJCC). Tumor tissue was further analyzed through molecular profiling, revealing microsatellite stability and mutations in the epidermal growth factor receptor (EGFR) and p53 genes (see  Supplementary Data ,  Supplementary Figure S1 ). Whole body CT-Scan with contrast of the lumbosacral column and pelvis was performed, showing the appearance of multiple lesions in all the bone segments and collapse of the 2  lumbar vertebra with cortical interruption ( Figures 1A, C, E ). A new whole-body CT-Scan on August 6th, 2019, was then performed and showed appearance of multiple metastases: cerebral lesions in the occipital and temporal area, multiple pulmonary nodules, subcutaneous nodules, and lymph nodes increased in volume in the left axillary, homolateral pectoral and, in the mesentery sites, hepatic metastases, lesion in the right kidney and further nodule in perirenal fat ( Figures 1B, D, F ).
case_images: PMC11324500_02
case_images: Radiographic evidence of hyperprogression after ICI of the second case. Pre-treatment with ICI, CT scan: (A) chest; (C-E) liver and spleen. Post treatment with ICI, CT scan with evidence of disease progression in the (B) chest and (D-F) liver and spleen on transverse and coronal planes.
case_images: fonc-14-1437325-g002.jpg
case_images: PMC11324500_02_fonc-14-1437325-g002.jpg
case_images: f2
case_images: The patient underwent whole body CT-Scan with iodine contrast and lymph node staging ultrasound, both negative for distant localizations of disease ( Figures 2A, C, E ). On September 16th, whole body CT-Scan with iodine contrast was performed, which highlighted multiple bilateral pulmonary nodules, mediastinal and right axillary pathological lymphadenopathies, dermal nodules and pathological subversion of the liver and spleen ( Figures 2B, D, F ).