Adenocarcinoma of the lung - EGFR-mutated

Case contributed by Dr Yair Glick

Presentation

Known NSCLC with bone metastases. Presented with chest pain, more on the left, exacerbated by deep breathing.

Patient Data

Age: 70 years
Gender: Female

Elevated right hemidiaphragm.
Atelectasis in RLL - no silhouette sign with mediastinum.

Expansile sclerotic matastasis in posterior arch of left 7th rib.

Sclerotic metastases in lower lumbar vertebrae and bilaterally in pelvic bones.

Normal intestinal gas distribution.

Heterogeneous soft tissue mass in RLL measuring 4.2 x 4.1 x 2.9 cm with atelectatic component - known primary.

Subcarinal soft tissue fullness embedded with with lymph node metastases. Small hyperenhancing left pretracheal (4L) lymph node suspicious for metastasis.

Osteoblastic metastases in left 7th rib, L4 and L5 vertebrae and pelvic bones.

Simple renal cyst in left kidney.

Case Discussion

Biopsy-proven EGFR-mutated adenocarcinoma of the lung with bone metastases. No response to osimertinib. CT done as part of follow-up before deciding on treatment modification.

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