case_images: PMC11780649_01
case_images: Treatment process of the patient.
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case_images: The treatment regimen after the second surgery included six cycles of chemotherapy (Pemetrexed:700 mg d  ; Carboplatin: 450 mg d  ) and 25 sessions of radiation therapy (Figure 1). It is worth noting that the patient first started using gefitinib in November 2016 and after 30 months, discontinued it due to inability to obtain higher therapeutic benefits (Figure 1).
case_images: Comparison of MRI before and after standard treatment. (A) Long T1 and long T2 signals can be seen in the left cerebellar hemisphere, T2 flair is high signal, the size is about 2.2 x 1.5 cm, and enhancement can be seen in the solid part (10/2016). (B) Metastatic tumor recurrence, about 3.2 x 2.5 cm in size, with enhancement visible in the solid portion (1/2018). (C) The size of the tumor was 3.3 x 4.1 cm on review after standard treatment, with increased volume and solid components compared to the 1/2018 (6/2018).
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case_images: Unfortunately, the final MRI during the last chemotherapy cycle revealed progressive disease (Figure 2).   The brain metastatic lesion increased in size from 2.2 x 1.5 cm before treatment to 3.3 x 4.1 cm after treatment. The patient's initial MRI in October 2016 revealed that the left cerebellar hemisphere could be visualized with long T1 and long T2 signals, with a high T2 flair, measuring approximately 2.2 x 1.5 cm, and enhancement was seen in the solid portion (as shown in Figure 2A). After treatments, a follow-up MRI in 1/2018 revealed a recurrence of the tumor, which was approximately 3.2 x 2.5 cm in size (Figure 2B), and after receiving standard treatment, the MRI results revealed a tumor size of 3.3 x 4.1 cm (Figure 2C).
case_images: Changes in cranial MRI of the patient during traditional Chinese medicine treatment. (A) Tumor size after traditional Chinese medicine treatment was 2.9 x 2.4 cm, decreased from 6/2018 (4/2019). (B) After continuation of treatment with traditional Chinese medicine, only a long T1 and long T2 with T2-Flair low signal was seen on follow-up, and no significant enhancement of cystic signal was seen (8/2023).
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case_images: At the patient's fourth visit, we were pleased to observe a significant reduction in the size of the space-occupying lesion in the left posterior cerebellar region compared to earlier MRI results (Figure 3A). At this visit, the treatment outcome was assessed as partial remission (PR)   (Figure 3B).
case_images: Changes in the patient's chest CT since the initiation of treatment. (A) Solid mass shadow in the lower lobe of the right lung, about 4.0 x 3.9 cm in size (10/2016). (B-E) Image shows no solid mass (11/2017, 10/2018, 4/2019, 8/2023).
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case_images: Since starting the therapeutic regimen, there has been a steady reduction in the size of the primary pulmonary lesion, which is now almost completely resolved (Figure 4). Figure 4 also includes the patient's CT results for comparison.