Abstract | RATIONALE: PATIENTS CONCERNS: In case report 1, 62-year-old man presented with scintillated scotomas at the level of the right eye; in case report 2, 69-year-old man presented with respiratory distress, persistent cough resistant to medical therapy, pain, and blurred vision. DIAGNOSES: In case report 1, fundus and ultrasonographic examination showed circumscribed choroid thickening with dome-like appearance compatible with repetitive lesion. Computed tomographic/y (CT) showed multiple bilateral pulmonary nodular formations and adenocarcinoma of the lung was diagnosed by a transbronchial biopsy.In case report 2, CT showed a primary lesion of 36 × 27 mm in the middle lobe with bilateral lung metastases and lymphadenopathies. Multiple hepatic metastases and minor suspicious bone repetitions. A liver biopsy made a diagnosis of adenocarcinoma compatible with pulmonary primitiveness. An ocular fluoroangiography evidenced a left choroidal metastasis. INTERVENTIONS: Case report 1, 2, medical treatment with Alectinib 1200 mg/day was initiated. OUTCOMES: In case report 1, a few days after beginning the treatment, both systemic symptoms like respiratory distress and low vision were palliated. Reassessment by CT confirmed treatment response. In case report 2, clinically, visus disorders had already improved 2 weeks after beginning treatment. CT showed pulmonary, nodal, and hepatic response. Stability of bone metastases occurred after 2 months. In addition, ocular ultrasonography documented the regression of previously reported lesions confirmed treatment response. LESSONS:
Alectinib works very well in intracranial metastases and is assumed to be so on the ocular ones as well, with benefit for the patient in quality of life.
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Authors | Elisa Gozzi, Francesco Angelini, Luigi Rossi, Valentina Leoni, Patrizia Trenta, Giuseppe Cimino, Silverio Tomao |
Journal | Medicine
(Medicine (Baltimore))
Vol. 99
Issue 27
Pg. e21004
(Jul 02 2020)
ISSN: 1536-5964 [Electronic] United States |
PMID | 32629718
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- Carbazoles
- Piperidines
- Protein Kinase Inhibitors
- ALK protein, human
- Anaplastic Lymphoma Kinase
- alectinib
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Topics |
- Aged
- Anaplastic Lymphoma Kinase
- Carbazoles
(therapeutic use)
- Carcinoma, Non-Small-Cell Lung
(drug therapy, secondary)
- Choroid Neoplasms
(diagnostic imaging, drug therapy, pathology, secondary)
- Humans
- Lung Neoplasms
(pathology)
- Male
- Middle Aged
- Piperidines
(therapeutic use)
- Protein Kinase Inhibitors
(therapeutic use)
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