Female genital tract metastasis of lung adenocarcinoma with EGFR mutations: Report of two cases

Figure 1 Case 1. A: Positron emission tomography-computed tomography (PET-CT) was performed before lung biopsy and showed hyper-metabolic activity in pulmonary lesions and the cervix uteri; B: PET-CT image showed hyper-metabolic activity in the inferior lobe of the right lung, where lung biopsy was performed; C: CT showed a right pulmonary mass characterized by a solid region with contiguous ground-glass areas, stellate borders, and pleural puckering before tyrosine kinase inhibitor treatment; D: CT showed a right pulmonary mass after 2 mo of gefitinib therapy, which indicated partial remission of tumor; E: CT image showed a right pulmonary mass after 4 mo of gefitinib therapy; F: Magnetic resonance imaging performed on April 12, 201 indicated brain metastasis.

Figure 2 Case 1. A: Cervical biopsy showed poorly differentiated adenocarcinoma; B: Pathological examination of specimens obtained from lung biopsy showed adenocarcinoma with necrosis, and immunohistochemical staining for thyroid transcription factor-1 was positive.

Figure 3 Case 2. A: Computed tomography (CT) scan showed lung lesions with cavity, as well as pleural effusion before tyrosine kinase inhibitor treatment; B: CT showed a right pulmonary mass after 3 mo of ecotinib therapy, which resulted in a partial response after 3 mo; C: CT scan showed pleural effusion after 1 mo of bevacizumab (Avastin) and icotinib therapy; D: CT scan showed pleural effusion after 4 mo of bevacizumab (Avastin) and icotinib therapy, without progression of initial tumor.

Figure 4 Case 2. A: Pathological examination of specimens obtained from lung biopsy showed adenocarcinoma, and immunohistochemical staining for thyroid transcription factor-1 (TTF-1) was positive; B: Ovarian biopsy revealed TTF-1 positive adenocarcinoma.