A Case of Squamous Cell Carcinoma of Unknown Primary that Responded to the Multi-Tyrosine Kinase Inhibitor Lenvatinib
Lenvatinib is an oral tyrosine kinase inhibitor of vascular endothelial growth factor receptors 1, 2, and 3, fibroblast growth factor receptors 1 through 4, as well as platelet-derived growth factor receptor α, RET, and KIT. At present, lenvatinib is used in the treatment of thyroid cancer and renal cell carcinoma. We herein report a case of a 67-year-old patient with squamous cell carcinoma of unknown primary who was effectively treated with lenvatinib. The patient was initially diagnosed as having un differentiated thyroid cancer, and after total thyroidectomy and bilateral lymph node dissection, lenvatinib was administered for the treatment of residual lymph node metastasis. A computed tomography scan after 1 month of lenvatinib administration showed marked regression of the lymph nodes, but in terstitial pneumonia was also detected. Because the drug lymphocyte stimulation test for lenvatinib was strongly positive, we concluded that the interstitial pneumonia was induced by lenvatinib. The interstitial pneumonia only improved by the withdrawal of lenvatinib. Finally, his thyroid tumor was diagnosed as a metastasis of squamous cell carcinoma; however, we were unable to identify the primary lesion. This is the first reported case of interstitial pneumonia induced by lenvatinib.Case Rep Oncol 2018;11:75 –80
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Gynecologic malignancies account for a significant proportion of disease-related morbidity and mortality in women throughout the world. Multimodality imaging, predominantly with PET, ultrasonography (US), computed tomography (CT), and MR imaging, plays an essential role in the diagnosis, staging, pretreatment planning, response assessment, and surveillance assessment of patients with such conditions. Therefore, in this issue of PET Clinics, we provide a series of state-of-the-art articles regarding the application of multimodality imaging to various gynecologic malignancies.
This article reviews normal variants and potential pitfalls encountered in PET assessment of gynecologic malignancies to provide useful information for the referring and reporting physicians.
The current status and future potential targets of non –18F-2-fluoro-2-deoxy-d-glucose (FDG) PET/computed tomography (CT) in 3 major gynecologic malignancies are discussed. Estrogen receptor–based 16alpha-18F-fluoro-17beta-estradiol (18F-FES) PET/CT has been investigated in (a) Uterine malignancies (both endometrial and myometrial pathologies) and ( b) ovarian carcinoma. For uterine tumors, FDG/FES standardized uptake value and/or uptake ratio showed a positive correlation with malignant transformation (ie, endometrial carcinoma and uterine sarcoma) and higher malignant grades, whereas higher 18F-FES uptake was...
The goal of this review is to discuss the current utility of fluorine-18 –fluorodeoxyglucose (FDG)–PET for radiation oncologists who treat gynecologic malignancies. FDG-PET/computed tomography (CT) is recommended for baseline assessment in cervical cancer and for staging in vulvar and vaginal cancer. The authors use FDG-PET/CT in definitive radiation treatment planni ng for cervical, vulvar, and vaginal cancer. PET may be helpful for salvage radiation treatment planning for any recurrent gynecologic malignancy. There are published data to support the use of PET in posttreatment evaluation of cervical and vulvar cancer.
PET and PET/computed tomography play a role in the staging, monitoring of response to therapy, and surveillance for cervical and ovarian cancers. Currently, it is also an integral part of the assessment of patients with endometrial cancer and other gynecologic malignancies, such as vaginal and vulvar cancers and uterine sarcomas. In this article, we discuss in detail and highlight the potential role of PET and PET/computed tomography in evaluating these gynecologic malignancies using illustrative cases with relevant imaging findings.
ConclusionThe results showed that accurate quantitative mapping of T1, , and proton density fat fraction with a single breath‐hold was achieved using our approach.
Could radiologists in either field comment on the differences between these 2 practice settings? I know that academics are expected to do research and private practice doctors have to read a lot of scans at a very fast pace. What about other factors: - Hours per week? - Environment/camaraderie? - Is PP reading pace truly uncomfortable to where job satisfaction goes down? Are there other downsides to PP radiology I don't know about? - Are there other downsides to academic radiology that I... Academic vs PP Radiology
CONCLUSIONS: The risk of cancer is low in Korean patients with AAV. PMID: 29465366 [PubMed - as supplied by publisher]