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.

Autor: Yuen CA; Department of Neurology, Neuro-Oncology Division, University of California, Irvine, CA, 92780,USA., Bao S; Department of Internal Medicine, Neurosciences Division, Community Regional Medical Center, Fresno, CA 93721, USA., Kong XT; Department of Neurology, Neuro-Oncology Division, University of California, Irvine, CA, 92780,USA.
Jazyk: angličtina
Zdroj: Biomarkers in medicine [Biomark Med] 2024; Vol. 18 (9), pp. 431-439. Date of Electronic Publication: 2024 May 24.
DOI: 10.1080/17520363.2024.2342231
Abstrakt: 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.
Databáze: MEDLINE