CTICasesCavitating Treatment Response of Pulmonary Adenocarcinoma to Erlotinib
Imaging findings
Baseline chest CT shows a solid, lobulated adenocarcinoma in the left lung. Five months after initiating treatment with the tyrosine kinase inhibitor erlotinib (Tarceva), follow-up CT demonstrates dramatic tumor melting with residual thin-walled cavitation at the site of the former mass. Pathological analysis of the resected lobe showed extensive treatment effect and necrosis with only minimal residual viable tumor.
Key takeaways
Target therapies like tyrosine kinase inhibitors (TKIs) can cause rapid tumor necrosis and liquefaction in EGFR-mutant lung adenocarcinomas, resulting in dramatic tumor cavitation. This cystic transformation represents a positive therapeutic response rather than disease progression or abscess formation, though pathology may still harbor microscopic foci of viable tumor cells.
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