case_images: PMC4968850_01
case_images: Case 1.. Notes: (A) Prior to therapy, chest CT scan shows a primary mass (arrow) in the right lung. (B) After two cycles of therapy, chest CT scan shows significant shrinkage of the mass (arrow). (C) After four cycles of therapy, chest CT scan shows further shrinkage of the mass (arrow), although not obvious.. Abbreviation: CT, computed tomography.
case_images: ott-9-4639Fig1.jpg
case_images: PMC4968850_01_ott-9-4639Fig1.jpg
case_images: f1-ott-9-4639
case_images: The right lung mass was found by computed tomography (CT) scan 9 months ago, when the patient underwent a routine physical examination (Figure 1A). Chest CT showed significant shrinkage of the primary mass after two cycles of therapy (Figure 1B). Interestingly, after four cycles of therapy, the lung mass showed further shrinkage, as evidenced by CT scan (Figure 1C).
case_images: PMC4968850_02
case_images: Case 2.. Notes: (A) Prior to therapy, chest CT scan shows a major lung nodule (arrow) in the right lung. (B) After two cycles of therapy, chest CT scan shows significant shrinkage of the mass (arrow). (C) After four cycles of therapy, chest CT scan shows further shrinkage of the mass (arrow).. Abbreviation: CT, computed tomography.
case_images: ott-9-4639Fig2.jpg
case_images: PMC4968850_02_ott-9-4639Fig2.jpg
case_images: f2-ott-9-4639
case_images: CT scan and magnetic resonance imaging scan, respectively (Figures 2A and 3A). CT-guided percutaneous needle biopsy of the mass proved adenocarcinoma, and the gene detection showed that the EGFR was wild type and the ALK rearrangement was positive. Chest CT showed significant shrinkage of the major lung nodule after two cycles of therapy (Figure 2B). Similarly, after four cycles of therapy, the major lung nodule showed further shrinkage as seen from CT scan (Figure 2C), and the brain metastasis mass also almost disappeared (Figure 3C).
case_images: Case 2.. Notes: (A) Prior to therapy, brain MRI scan shows major brain metastasis nodules (arrow). (B and C) After two or four cycles of therapy, brain MRI scan shows significant shrinkage of the major brain metastasis nodules (arrow).. Abbreviation: MRI, magnetic resonance imaging.
case_images: ott-9-4639Fig3.jpg
case_images: PMC4968850_02_ott-9-4639Fig3.jpg
case_images: f3-ott-9-4639
case_images: CT scan and magnetic resonance imaging scan, respectively (Figures 2A and 3A). CT-guided percutaneous needle biopsy of the mass proved adenocarcinoma, and the gene detection showed that the EGFR was wild type and the ALK rearrangement was positive. Importantly, brain magnetic resonance imaging showed that the major brain metastasis mass almost disappeared after two cycles of therapy (Figure 3B). Similarly, after four cycles of therapy, the major lung nodule showed further shrinkage as seen from CT scan (Figure 2C), and the brain metastasis mass also almost disappeared (Figure 3C).
case_images: PMC4968850_03
case_images: Case 3.. Notes: (A) Prior to therapy, chest CT scan shows a major lung mass (arrow) in the right lung. (B) After two cycles of therapy, chest CT scan shows significant shrinkage of the mass (arrow). (C) After four cycles of therapy, chest CT scan shows further shrinkage of the mass (arrow).. Abbreviation: CT, computed tomography.
case_images: ott-9-4639Fig4.jpg
case_images: PMC4968850_03_ott-9-4639Fig4.jpg
case_images: f4-ott-9-4639
case_images: CT scan 3 months ago (Figure 4A). CT-guided percutaneous needle biopsy of the lung mass proved adenocarcinoma, and the gene detection showed that a deletion mutation in the exon 19 of the EGFR and the ALK rearrangement was negative. Chest CT showed significant shrinkage of the major lung nodule after two cycles of therapy (Figure 4B). Similarly, after four cycles of therapy, the major lung nodule showed further shrinkage as seen from CT scan (Figure 4C).