case_images: PMC11324221_01
case_images: a Clinical picture: lesion at the level of the upper right incisor compatible with IMT. b Clinical picture: complete response after starting treatment with alectinib.
case_images: cro-2024-0017-0001-539739_F01.jpg
case_images: PMC11324221_01_cro-2024-0017-0001-539739_F01.jpg
case_images: F1
case_images: IMT relapse, 4 in the last 6 months with pathological anatomy compatible with recurrence of IMT. In February 2019, patient presented new growth of the lesion (Fig. 1.) accompanied by facial pain and limitation for oral intake, the case was sent to a reference center for soft tissue tumors (Virgen del Rocio University Hospital), an image reevaluation was performed (Fig. 2-4), observing a local relapse measuring 22 x 17 mm in the axial plane, Additionally, recurrence was observed at multiple levels, with nodules noted in contact with the nasal spine measuring 8 mm, and multiple nodules in more cranial planes extending to the base of the nasal vestibule. ALK translocation it was decided in April 2019 to initiate targeted therapy with alectinib at dose of 600 mg per day, resembling, the treatment protocol in ALK-positive lung cancer. A complete response was observed according to RECIST 1.1 criteria in the first reevaluation, which has been maintained to date (Fig. 1b), with good treatment tolerance and no notable acute toxicities, until June 2022 at this moment the patient presented G2-3 xeroderma, in this context one dose reduction was performed to 450 mg per day with very good tolerance to date.
case_images: a Computed axial tomography image showing contrast-enhancing nodular lesion that partially occupies the upper vestibule, measuring 22 mm x 17 mm in diameter. January 2018. b Computed axial tomography image showing complete radiological response according to RECIST 1.1 criteria. August 2018.
case_images: cro-2024-0017-0001-539739_F02.jpg
case_images: PMC11324221_01_cro-2024-0017-0001-539739_F02.jpg
case_images: F2
case_images: IMT relapse, 4 in the last 6 months with pathological anatomy compatible with recurrence of IMT. In February 2019, patient presented new growth of the lesion (Fig. 1.) accompanied by facial pain and limitation for oral intake, the case was sent to a reference center for soft tissue tumors (Virgen del Rocio University Hospital), an image reevaluation was performed (Fig. 2-4), observing a local relapse measuring 22 x 17 mm in the axial plane, Additionally, recurrence was observed at multiple levels, with nodules noted in contact with the nasal spine measuring 8 mm, and multiple nodules in more cranial planes extending to the base of the nasal vestibule.
case_images: Images of the evolution of target lesion response during treatment. a, b Focal nodular lesion measuring 12 x 13 mm with contrast hyperenhancement, partially occupying the upper vestibule, well defined, slightly heterogeneous. c, d CT scan after 5 months of treatment with alectinib in pathological complete response according to RECIST 1.1 criteria.
case_images: cro-2024-0017-0001-539739_F03.jpg
case_images: PMC11324221_01_cro-2024-0017-0001-539739_F03.jpg
case_images: F3
case_images: IMT relapse, 4 in the last 6 months with pathological anatomy compatible with recurrence of IMT. In February 2019, patient presented new growth of the lesion (Fig. 1.) accompanied by facial pain and limitation for oral intake, the case was sent to a reference center for soft tissue tumors (Virgen del Rocio University Hospital), an image reevaluation was performed (Fig. 2-4), observing a local relapse measuring 22 x 17 mm in the axial plane, Additionally, recurrence was observed at multiple levels, with nodules noted in contact with the nasal spine measuring 8 mm, and multiple nodules in more cranial planes extending to the base of the nasal vestibule.
case_images: Evolution of the lung metastasis. a, b January 2018, image of mass approximately 56 mm in maximum diameter, located in the right lower lobe. c August 2019, control CT scan after lobectomy.
case_images: cro-2024-0017-0001-539739_F04.jpg
case_images: PMC11324221_01_cro-2024-0017-0001-539739_F04.jpg
case_images: F4
case_images: IMT relapse, 4 in the last 6 months with pathological anatomy compatible with recurrence of IMT. In February 2019, patient presented new growth of the lesion (Fig. 1.) accompanied by facial pain and limitation for oral intake, the case was sent to a reference center for soft tissue tumors (Virgen del Rocio University Hospital), an image reevaluation was performed (Fig. 2-4), observing a local relapse measuring 22 x 17 mm in the axial plane, Additionally, recurrence was observed at multiple levels, with nodules noted in contact with the nasal spine measuring 8 mm, and multiple nodules in more cranial planes extending to the base of the nasal vestibule.
case_images: Timeline. Disease evolution.
case_images: cro-2024-0017-0001-539739_F05.jpg
case_images: PMC11324221_01_cro-2024-0017-0001-539739_F05.jpg
case_images: F5
case_images: Last image review was performed, maintaining a complete response (Fig. 5).