case_images: PMC10776595_01
case_images: MRI of the brain. (A) Basal brain metastasis; (B) with partial response to osimertinib treatment; (C) progression after 14 cycles of osimertinib; (D) complete response after receiving SRS 20 Gy treatment
case_images: etat-04-1002191-g001.jpg
case_images: PMC10776595_01_etat-04-1002191-g001.jpg
case_images: fig1
case_images: In October 2020, cerebral oligoprogression was reported due to an increase in the frontal lesion and single-dose radiosurgery (SRS) up to 20 grays (Gy) was performed maintaining osimertinib afterward, as a systemic treatment (Figure 1).
case_images: PET-CT with 18-fluorodeoxyglucose (FDG). (A) Hypermetabolism of the basal parahiliar right mass; (B) hypermetabolism of the bone metastasis at D9; (C) initial response to osimertinib in the lung mass; (D) initial response to osimertinib in the bone lesion; (E) progression of the parahiliar mass after 32 cycles of treatment; (F) complete response maintained in the bone
case_images: etat-04-1002191-g002.jpg
case_images: PMC10776595_01_etat-04-1002191-g002.jpg
case_images: fig2
case_images: In November 2021, the CT showed an increase in the lung lesion, maintaining a complete response in the rest of the locations, including bone lesion at D9, by PET-CT (Figure 2).
case_images: FISH of MET. MET amplification assessed by FISH (x1,000) showing MET high amplification in green (copy range 9-13; ratio MET/chromosome7: > 5)
case_images: etat-04-1002191-g003.jpg
case_images: PMC10776595_01_etat-04-1002191-g003.jpg
case_images: fig3
case_images: MET/chromosome7: > 5), which was confirmed by fluorescence in situ hybridization (FISH, ZytoLight  SPEC MET/CEN7 Dual Color Probe, ZytoVision) (Figure 3). MET exon 14 skipping was also identified in a low number of reads (2,848).