A non-enhancing, T2 fluid-attenuated inversion recovery hyperintense, diffusion-restricting brainstem lesion in an EGFR tyrosine kinase inhibitor-treated non-small-cell lung cancer patient.

IF 1.9 4区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Biomarkers in medicine Pub Date : 2024-01-01 Epub Date: 2024-05-24 DOI:10.1080/17520363.2024.2342231
Carlen A Yuen, Silin Bao, Xiao-Tang Kong
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Abstract

Leptomeningeal metastasis (LM) is a devastating complication of malignancy. Diagnosis relies on both contrast enhancement on imaging and malignant cells in cerebral spinal fluid cytology. Though early detection and prompt intervention improves survival, the detection of LM is limited by false negatives. A rare brainstem imaging finding uncovered specifically in EGFR mutation-positive lung cancer patients may represent an early sign of LM. This sign demonstrates high signal on T2 fluid-attenuated inversion recovery and diffusion-weighted imaging sequences, but paradoxically lacks correlative contrast enhancement. Here we report a case of a 72-year-old female EGFR-positive lung cancer patient who developed this lesion following treatment with two first-generation EGFR tyrosine kinase inhibitors then showed subsequent response to osimertinib, an irreversible third-generation EGFR tyrosine kinase inhibitor.

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一名接受表皮生长因子受体酪氨酸激酶抑制剂治疗的非小细胞肺癌患者脑干出现非增强、T2流体增强反转恢复高强化、弥散限制性病变。
脑膜转移(LM)是恶性肿瘤的一种破坏性并发症。诊断依赖于造影剂的对比增强和脑脊液细胞学检查中的恶性细胞。虽然早期发现和及时干预能提高生存率,但 LM 的检测受到假阴性的限制。在表皮生长因子受体突变阳性的肺癌患者中发现的一种罕见的脑干成像发现可能是肺癌的早期征兆。该征象在 T2 液体减弱反转恢复和弥散加权成像序列上表现为高信号,但奇怪的是缺乏相关的对比度增强。在此,我们报告了一例72岁的女性表皮生长因子受体(EGFR)阳性肺癌患者,她在接受两种第一代EGFR酪氨酸激酶抑制剂治疗后出现了这种病变,随后对不可逆的第三代EGFR酪氨酸激酶抑制剂奥希替尼产生了反应。
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来源期刊
Biomarkers in medicine
Biomarkers in medicine 医学-医学:研究与实验
CiteScore
3.80
自引率
4.50%
发文量
86
审稿时长
6-12 weeks
期刊介绍: Biomarkers are physical, functional or biochemical indicators of physiological or disease processes. These key indicators can provide vital information in determining disease prognosis, in predicting of response to therapies, adverse events and drug interactions, and in establishing baseline risk. The explosion of interest in biomarker research is driving the development of new predictive, diagnostic and prognostic products in modern medical practice, and biomarkers are also playing an increasingly important role in the discovery and development of new drugs. For the full utility of biomarkers to be realized, we require greater understanding of disease mechanisms, and the interplay between disease mechanisms, therapeutic interventions and the proposed biomarkers. However, in attempting to evaluate the pros and cons of biomarkers systematically, we are moving into new, challenging territory. Biomarkers in Medicine (ISSN 1752-0363) is a peer-reviewed, rapid publication journal delivering commentary and analysis on the advances in our understanding of biomarkers and their potential and actual applications in medicine. The journal facilitates translation of our research knowledge into the clinic to increase the effectiveness of medical practice. As the scientific rationale and regulatory acceptance for biomarkers in medicine and in drug development become more fully established, Biomarkers in Medicine provides the platform for all players in this increasingly vital area to communicate and debate all issues relating to the potential utility and applications. Each issue includes a diversity of content to provide rounded coverage for the research professional. Articles include Guest Editorials, Interviews, Reviews, Research Articles, Perspectives, Priority Paper Evaluations, Special Reports, Case Reports, Conference Reports and Company Profiles. Review coverage is divided into themed sections according to area of therapeutic utility with some issues including themed sections on an area of topical interest. Biomarkers in Medicine provides a platform for commentary and debate for all professionals with an interest in the identification of biomarkers, elucidation of their role and formalization and approval of their application in modern medicine. The audience for Biomarkers in Medicine includes academic and industrial researchers, clinicians, pathologists, clinical chemists and regulatory professionals.
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