case_images: PMC4869644_01
case_images: Chest CT imaging.. Notes: (A) The image shows an enhancing mass (42x40 mm2) in the lower lobe of the right lung before the treatment; white arrow indicates the primary lesions. (B) The figure shows that the pulmonary lesions (white arrow) had little response to the first-line chemotherapy. (C) It reveals progression of the disease (white arrow) after the second-line chemotherapy.. Abbreviation: CT, computed tomography.
case_images: ott-9-2743Fig1.jpg
case_images: PMC4869644_01_ott-9-2743Fig1.jpg
case_images: f1-ott-9-2743
case_images: In the chest CT, an enhancing mass (Figure 1) was found in the lower lobe of the right lung, with right hilum and mediastinal lymph node metastases, and enhancements in multifocal muscular neoplasms (Figure 2), suggestive of metastatic involvement.
case_images: CT of the chest.. Notes: (A) CT shows enhancing masses in right subscapularis (black arrow) and pectoralis (white arrow) muscles before the treatment. (B) CT reveals an enlargement of the masses (white and black arrows) after first-line chemotherapy and (C) an increase in size of the mass (white arrow) after second-line chemotherapy and an stable subscapularis mass (black arrow) for the radiotherapy.. Abbreviation: CT, computed tomography.
case_images: ott-9-2743Fig2.jpg
case_images: PMC4869644_01_ott-9-2743Fig2.jpg
case_images: f2-ott-9-2743
case_images: In the chest CT, an enhancing mass (Figure 1) was found in the lower lobe of the right lung, with right hilum and mediastinal lymph node metastases, and enhancements in multifocal muscular neoplasms (Figure 2), suggestive of metastatic involvement. During the second cycle of chemotherapy, the skeletal muscular metastases enlarged rapidly, with pain escalating out of medical control (Figure 2B).
case_images: Histopathologic study of the CT-guided biopsy from the lung mass, showing poorly differentiated adenocarcinoma (H&E, x400).. Abbreviations: CT, computed tomography; H&E, hematoxylin and eosin.
case_images: ott-9-2743Fig3.jpg
case_images: PMC4869644_01_ott-9-2743Fig3.jpg
case_images: f3-ott-9-2743
case_images: A CT-guided percutaneous fine-needle aspiration biopsy (FNAB) of the lung mass was performed, and it provided a histopathological diagnosis of adenocarcinoma, which is consistent with the known subcutaneous tumor (Figure 3).
case_images: Orbital mass secondary to metastatic lung cancer on axial, enhanced, T1-weighted, and T2-weighted MR images.. Notes: (A) Before treatment, a right retrobulbar extraconal mass (20x15x20 mm3) (white arrow) is shown pressing on the optic nerve, and a severe globe proptosis can be noticed. (B) A significant reduction of the intraorbital mass (white arrow) can be found after administration of a radiation dose of 30 Gy. (C) The mass (white arrow) decreases in size significantly after administration of the whole radiation dose of 50 Gy. The proptosis and visual acuity is evident on the MRI scan.. Abbreviation: MRI, magnetic resonance imaging.
case_images: ott-9-2743Fig4.jpg
case_images: PMC4869644_01_ott-9-2743Fig4.jpg
case_images: f4-ott-9-2743
case_images: A diagnostic magnetic resonance imaging (MRI) of the nasopharynx was repeated, and it demonstrated multifocal skeletal muscular metastases and a right retro bulbar extraconal mass (20x15x20 mm3) that was increasing in size, pushing the eyeball forward (Figure 4A), and two enhancing nodules in brain (Figure 5A). In a repeated MRI scan, the orbital metastasis showed a significant response to the treatment (Figure 4B) and two more lesions were seen in the brain (Figure 5B). When the treatment was completed, he reported relief from the pain in the metastatic sites and improvement in visual acuity (Figure 4C).
case_images: Brain metastases on the MR images.. Notes: (A) Metastasis in the left cerebellar hemisphere (white arrow) and left temporal lobe (not shown). (B) Two new lesions (white arrows) emerging at the end of the second circle of the first-line chemotherapy. (C) A significant response to the whole brain radiation is observed.. Abbreviation: MR, magnetic resonance.
case_images: ott-9-2743Fig5.jpg
case_images: PMC4869644_01_ott-9-2743Fig5.jpg
case_images: f5-ott-9-2743
case_images: A diagnostic magnetic resonance imaging (MRI) of the nasopharynx was repeated, and it demonstrated multifocal skeletal muscular metastases and a right retro bulbar extraconal mass (20x15x20 mm3) that was increasing in size, pushing the eyeball forward (Figure 4A), and two enhancing nodules in brain (Figure 5A). In a repeated MRI scan, the orbital metastasis showed a significant response to the treatment (Figure 4B) and two more lesions were seen in the brain (Figure 5B).