Department of Ultrasonography, Shanghai Chest Hospital, Shanghai Jiao Tong University, Xuhui District, West Huaihai Road No. 241, Shanghai, China.
Department of Cardiology, Shanghai Fifth People's Hospital, Fudan University, Minhang District, Heqing Road No. 801, Shanghai, China.
Cancer Treat Res Commun. 2021;27:100373. doi: 10.1016/j.ctarc.2021.100373. Epub 2021 Apr 9.
The oral small-molecule tyrosine kinase inhibitor (TKI), crizotinib has been approved as a first-generation anaplastic lymphoma kinase (ALK) inhibitor in treatment of advanced ALK-positive non-small cell lung cancer (NSCLC). Recently, development of complex renal cysts has been reported with crizotinib usage, highlighting the importance of accurate differentiation between complex renal cysts and new metastasis in NSCLC. Here we describe a case study with confirmed EGFR wild-type and ALK-rearranged lung adenocarcinoma who developed complex renal cysts combined with hemorrhage during crizotinib treatment, with no abnormal clinical symptoms or kidney functions observed. Interestingly, without crizotinib treatment termination or reduction, the complex hemorrhagic renal cysts regressed with self-limiting and healing. The combined usage of ultrasound, CT and MRI techniques in the presented case allowed proper monitoring of the internal changes within complex renal cysts. The patient provided written informed consent authorizing publication of clinical case. Thus, better understanding of the imaging features of crizotinib-related renal cysts combined with hemorrhage would avoid misdiagnoses as a new metastatic renal mass or the aggravation of the primary disease, therefore avoiding further invasive investigation.
口服小分子酪氨酸激酶抑制剂（TKI）克唑替尼已被批准用于治疗晚期间变性淋巴瘤激酶（ALK）阳性非小细胞肺癌（NSCLC）的第一代 ALK 抑制剂。最近，有报道称在使用克唑替尼时会出现复杂的肾囊肿，这突出了准确区分 NSCLC 中复杂肾囊肿和新转移的重要性。在这里，我们描述了一例经证实为 EGFR 野生型和 ALK 重排的肺腺癌患者，在克唑替尼治疗期间出现复杂的肾囊肿合并出血，但无异常临床症状或肾功能观察到。有趣的是，在没有停止或减少克唑替尼治疗的情况下，复杂的出血性肾囊肿自行消退并愈合。在本例中联合使用超声、CT 和 MRI 技术可以对复杂肾囊肿内的内部变化进行适当的监测。该患者提供了书面知情同意书，授权发表临床病例。因此，更好地了解与克唑替尼相关的肾囊肿合并出血的影像学特征可以避免误诊为新的转移性肾肿块或原发性疾病的恶化，从而避免进一步的侵入性检查。
