case_images: PMC11074396_01
case_images: Non-small cell lung cancer (NSCLC) treatment flow chart including imaging manifestations, (A) lung CT revealed a dense mass that measured approximately 2.1x3.0 cm in size at initial diagnosis. (B) the CT scan reported that the lesion size was about 1.7x1.3 cm after the first-line treatment. (C) the brain MRI showed an abnormal enhancement before the second-line treatment. (D) no brain lesions were observed after two courses of second-line treatment. (E) PET-CT scan revealed metastasis in the left cervical, left submaxillary lymph nodes, and adrenal glands. (F) a CT scan showed an enlargement of the lesion in the superior lobe of the lung that measured approximately 4.1x3.6 cm. (G) a PET-CT scan disclosed that the lung lesion was about 6.5x4.4 cm, and there were 1.6 cm and 1.8 cm masses in the left and right adrenal glands, respectively. (H) the PET-CT scan showed new metastases in the right renal para-vascular lymph nodes and para-aortic lymph nodes. There was an increase in the size of the bilateral adrenal lesions (left: 3.9 cm, right: 4.7 cm), and the lung lesion measured 6.6x5.2 cm. The best response during per line and results of gene detections. SD, stable disease; PR, partial response.
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case_images: And there were multiple ground glass nodules in both lungs, about 0.5-1.2 cm in diameter, with the larger ones being considered space-occupying lesions ( Figure 1A ). After maintenance treatment with pemetrexed + bevacizumab for 2 courses on January 9, 2020, the lesion in the superior lobe of the left lung and the enlarged lymph nodes of the left hilum were treated with radiation therapy from March 3 to April 20. After the radiation therapy, the CT scan reported that the lesion size was about 1.7x1.3 cm ( Figure 1B ). The detection of an abnormal enhancement in the left frontal lobe and the posterior horn of the lateral ventricle on a brain magnetic resonance imaging scan on July 24 indicated disease progression with brain involvement ( Figure 1C ). After two courses of treatment, no brain lesions were observed ( Figure 1D ), and a slight reduction in the size of their lung lesions was noted, resulting in an overall efficacy evaluation as a partial response (PR). Tomography (PET-CT) scan conducted on May 6, 2021 since she noticed a lump on the left neck, revealing metastasis in the left cervical, left submaxillary lymph nodes, and adrenal glands. The right adrenal gland exhibited a mass with a diameter of 1.9 cm, and the left one was full, which was considered tumor progression ( Figure 1E ). The third-line treatment consisted of 6 courses of albumin-bound paclitaxel + cisplatin starting on May 8, and after 4 courses of treatment, the overall efficacy was evaluated as PR and the lung lesion size was about 1.7x1.1 cm. Figure 1F ), indicating further tumor progression. For the fourth-line treatment, local radiofrequency ablation could not be performed due to the lesion's proximity to blood vessels. A new reassessment through a PET-CT scan on May 15, 2022 disclosed that the size of the lesion in the lung was about 6.5x4.4 cm with increasing metabolic activity, and there were 1.6 cm and 1.8 cm masses in the left and right adrenal glands, respectively ( Figure 1G ). There was an increase in the size of the bilateral adrenal lesions (left: 3.9 cm, right: 4.7 cm), and the lung lesion measured approximately 6.6x5.2 cm ( Figure 1H ).
case_images: Computed tomography shows the comparison of lung lesions before (A) and after (B) the treatment of dabrafenib plus trametinib.
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case_images: Subsequently, the treatment of olaparib was ceased and the sixth-line treatment started on February 28, involving a regimen of albumin-bound paclitaxel + bevacizumab administered over 6 courses, resulting in an assessment of SD ( Figure 2A ). On November 5, the latest reexamination revealed that the size of the lung lesion was measured approximately 6.4x3.7 cm, and the right adrenal nodule reduced in size compared to previous assessments, while the left one displayed no significant changes ( Figure 2B ).