case_images: PMC11321957_01
case_images: CT scan for EIMS: A large mass with unclear boundaries in the left anterior mediastinum measures 10.1 * 9.4 cm (A), a partial response was revealed after 1 month following lorlatinib (B), Comparison of contrast-enhanced CT of the chest at 1 month (C) and 3 months (D) after treatment with Lorlatinib.
case_images: fphar-15-1401428-g001.jpg
case_images: PMC11321957_01_fphar-15-1401428-g001.jpg
case_images: F1
case_images: A 34-year-old female presented to local hospital with productive cough and fever (performance status (PS) score: 3) and was found to have an anterior mediastinal occupation combined pleural effusion on chest computed tomography (CT), measuring approximately 10.1 * 9.4 cm (Figure 1A). After 24 days of lorlatinib treatment, a follow-up chest CT scan revealed that the left anterior mediastinal mass had notably decreased to 6.9 * 5.6 cm (PS score: 1) (Figure 1B). Additionally, the left pleural effusion showed signs of reduction. Following 3 months of lorlatinib treatment, continued tumor regression was evident (Figures 1C, D).
case_images: PET-CT scan: The tumor with a size of 14.8 * 9.9 cm is limited to the mediastinum without metastasis at baseline (A), continuous partial response was demonstrated after 15 months following lorlatinib (B).
case_images: fphar-15-1401428-g002.jpg
case_images: PMC11321957_01_fphar-15-1401428-g002.jpg
case_images: F2
case_images: Positron emission tomography-computed tomography (PET-CT) scan confirmed the presence of a large irregular mass in the left anterior mediastinum with 14.8 *9.9 cm, showing a high standardized uptake value (SUV) of 29.2 (Figure 2A). In March 2023, the follow-up assessment revealed that the tumor size had significantly reduced to approximately 2.3 * 1.3 cm, and SUV value was 4.1 by PET-CT (PS score: 0) (Figure 2B).
case_images: Chest-enhanced MRI with contrast: The tumor infiltrates the mediastinal vessels after 3 months of treatment with Lorlatinib (A), tumor separates from the surrounding blood vessels after 15 months of treatment with Lorlatinib (B).
case_images: fphar-15-1401428-g003.jpg
case_images: PMC11321957_01_fphar-15-1401428-g003.jpg
case_images: F3
case_images: Chest-enhanced magnetic resonance imaging (MRI) indicated that the tumor was well-defined and separate from the surrounding blood vessels (Figure 3).