Publish in this journal
Journal Information
Vol. 52. Issue 10.
Pages 531-532 (October 2016)
Vol. 52. Issue 10.
Pages 531-532 (October 2016)
Clinical Image
DOI: 10.1016/j.arbr.2016.07.014
Full text access
Cavitating Lung Cancer as Response to Bevacizumab Treatment
Cavitación de adenocarcinoma de pulmón como respuesta al tratamiento con bevacizumab
Lucía Fernández Rodríguez
Corresponding author

Corresponding author.
, Alicia Linares Beltrán, Isabel Torres Sánchez
Sección de Imagen Cardiotorácica, Servicio de Radiodiagnóstico, Hospital Universitario La Paz, Madrid, Spain
Article information
Full Text
Download PDF
Figures (1)
Full Text

A 57-year-old woman, former smoker, consulted due to irritative cough. Chest radiograph showed a right paratracheal mass and a nodule in the left lower lobe (LLL) with characteristics of malignancy. CT revealed a solid, necrotized mass with peripheral enhancement in the right upper lobe (RUL) (Fig. 1A and C), and another similar subpleural lesion in the LLL (Fig. 1B and D), and pathologically enlarged hilar lymph nodes. All lesions were observed on PET.

Fig. 1.

(A and C) Axial CT slices in the mediastinal and lung windows, respectively. A solid mass 6cm×4cm with infiltrative margins, containing necrosis, and peripheral enhancement in the posterior segment of the RUL adjacent to the posterior pleura. (B and D) Axial CT slices in the mediastinal and lung windows. Another solid lesion is seen in the LLL, adjacent to the diaphragmatic pleura, with infiltrative contours and less necrosis. (E and F) Axial CT slices in lung window, 6 months after starting bevacizumab treatment. In E, the RUL lesion can be seen to be larger, cavitated and with no solid component, and in F, the solid tumor in the LLL is smaller with lower attenuation than in images B and D.

FNAB was performed in both lesions, and the pathology report found EGFR-mutation negative and ALK-mutation negative lung adenocarcinoma. Treatment was started with taxol–carboplatin–bevacizumab (antiangiogenic), followed by maintenance bevacizumab.

In the follow-up CT, the RUL lesion had increased in size, with cavitation and reduced solid component (Fig. 1E). The LLL tumor and lymphadenopathy had reduced in size and attenuation (Fig. 1F).

There have been far-reaching changes in the treatment of advanced lung cancer, with the introduction of molecular targets, and immunological and antiangiogenic therapy that have different mechanisms of action and patterns of response from those of conventional chemotherapy. The effects of antiangiogenics include not only change in size, but also the appearance of cavitation (20%), considered a criterion for good treatment response. Although the overall size of the lesions increases, cavitation and reduced solid component are considered a positive response.1

J. Ferreirós, B. Cabeza, A. Gayete, M. Sánchez, M.I. Torres, M. Cobo, et al.
Recomendaciones para el diagnóstico radiológico y la valoración de la respuesta terapéutica en el cáncer de pulmón. Consenso nacional de la Sociedad Española de Radiología Médica y la Sociedad Española de Oncología Médica.
Radiologia, 57 (2015), pp. 66-78

Please cite this article as: Fernández-Rodríguez L, Linares-Beltrán A, Torres-Sánchez, I. Cavitación de adenocarcinoma de pulmón como respuesta al tratamiento con bevacizumab. Arch Bronconeumol. 2016;52:531–532.

Copyright © 2015. SEPAR
Archivos de Bronconeumología (English Edition)

Subscribe to our newsletter

Article options
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.