Discordant Cavitary Changes: A Radiological Dilemma in Invasive Mucinous Adenocarcinoma: A Case Report.
- 1Department of Respiratory Medicine Japanese Red Cross Ise Hospital Ise Mie Japan.
Abstract
Treatment-related cavitary transformation in lung cancer may complicate radiological response assessment. We report a man in his 70s with stage IVA invasive mucinous adenocarcinoma treated with atezolizumab, bevacizumab, carboplatin and paclitaxel. After two cycles, CT showed enlargement of cavitary components despite regression of solid tumour components, making response assessment difficult. After two additional cycles, the pulmonary lesions showed little change, whereas progression of the Th4 bone metastasis led to an overall assessment of progressive disease and a change to docetaxel plus ramucirumab. Thereafter, the cavities further enlarged while the cavity walls progressively thinned and the solid components appeared to regress. This case illustrates that marked multifocal cavitary transformation may produce discordant morphological changes, limiting response assessment based on imaging alone. Serum CEA and SLX levels remained within the normal ranges at diagnosis and throughout treatment.
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BibTeX
@article{nigi2026discordant,
title = {{Discordant Cavitary Changes: A Radiological Dilemma in Invasive Mucinous Adenocarcinoma: A Case Report.}},
author = {Akina Nigi and Noritaka Miya and Keisuke Iwamoto and Hidetoshi Itani and Shigeto Kondou},
journal = {Respirology case reports},
year = {2026},
month = oct,
doi = {10.1002/rcr2.70791},
url = {https://europepmc.org/article/MED/42903238},
note = {CC BY},
}
RIS
TY - JOUR
TI - Discordant Cavitary Changes: A Radiological Dilemma in Invasive Mucinous Adenocarcinoma: A Case Report.
AU - Akina Nigi
AU - Noritaka Miya
AU - Keisuke Iwamoto
AU - Hidetoshi Itani
AU - Shigeto Kondou
PY - 2026
DA - 2026/10/19
JO - Respirology case reports
DO - 10.1002/rcr2.70791
UR - https://europepmc.org/article/MED/42903238
AB - Treatment-related cavitary transformation in lung cancer may complicate radiological response assessment. We report a man in his 70s with stage IVA invasive mucinous adenocarcinoma treated with atezolizumab, bevacizumab, carboplatin and paclitaxel. After two cycles, CT showed enlargement of cavitary components despite regression of solid tumour components, making response assessment difficult. After two additional cycles, the pulmonary lesions showed little change, whereas progression of the Th4 bone metastasis led to an overall assessment of progressive disease and a change to docetaxel plus ramucirumab. Thereafter, the cavities further enlarged while the cavity walls progressively thinned and the solid components appeared to regress. This case illustrates that marked multifocal cavitary transformation may produce discordant morphological changes, limiting response assessment based on imaging alone. Serum CEA and SLX levels remained within the normal ranges at diagnosis and throughout treatment.
SN - 2051-3380
ER -