case_images: PMC6759207_01
case_images: Sagittal T1-weighted (T1w) spinal MRI.. Notes: (A) Baseline MRI showed ribbon-like enhancement of the spinal pia mater (red arrow) and the multiple osseous destruction sites (white arrow). (B) Repeat MRI after 4 months of treatment, showed reduced enhancement of the spinal pia mater (red arrow) and stable osseous destruction sites (white arrow).
case_images: OTT-12-7785-g0001.jpg
case_images: PMC6759207_01_OTT-12-7785-g0001.jpg
case_images: F0001
case_images: Plasma carcinoembryonic antigen (CEA) levels were markedly increased, and MRI discovered LMs (Figures 1A and 2A), which were further confirmed by positive CSF cytology. Her CEA level and MRI findings remained stable (Figures 1B and 2B) for 8 months without any notable side effects during treatment.
case_images: Axial T1w C+ craniocerebral MRI.. Notes: (A) Baseline MRI showed three patches of enhancement along the sulci (white arrows). (B) After 4 months of treatment, MRI showed reduced enhancement of all lesions (white arrows).
case_images: OTT-12-7785-g0002.jpg
case_images: PMC6759207_01_OTT-12-7785-g0002.jpg
case_images: F0002
case_images: Plasma carcinoembryonic antigen (CEA) levels were markedly increased, and MRI discovered LMs (Figures 1A and 2A), which were further confirmed by positive CSF cytology. Her CEA level and MRI findings remained stable (Figures 1B and 2B) for 8 months without any notable side effects during treatment.
case_images: PMC6759207_02
case_images: PMC6759207_03
case_images: Axial T1w C+ craniocerebral MRI.. Notes: (A) Baseline MRI showed a patch of inhomogeneous enhancement along the sulci (white arrow). (B) MRI after a 3-month interval showed a shrunken lesion (white arrow). (C) Repeat MRI in May 2019 showed a reduced lesion (white arrow).
case_images: OTT-12-7785-g0003.jpg
case_images: PMC6759207_03_OTT-12-7785-g0003.jpg
case_images: F0003
case_images: PET-CT and MRI (Figure 3A). Plasma EGFR L858R mutation testing produced positive results, while the test for T790M was negative. Osimertinib at 80 mg daily was administered, which decreased the CEA levels, alleviated neurological signs and symptoms, and reduced the lesion size (Figure 3B). At the last follow-up in May 2019, a repeat MRI revealed a shrunken lesion of LM (Figure 3C).