A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA

We report a case of radiation fibrosis appearing as mass-like consolidation, which was difficult to distinguish from local recurrence. A 72-year-old woman was diagnosed as having primary lung cancer (cT1N0M0 stage IA) in the right upper lobe and was treated with SBRT of 48 Gy in 4 fractions. After 1...

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Main Authors: Kotaro Terashima, Yoshiyuki Shioyama, Satoshi Nomoto, Saiji Ohga, Takeshi Nonoshita, Kayoko Ohnishi, Kazushige Atsumi, Hidetake Yabuuchi, Hideki Hirata, Hiroshi Honda
Format: Article
Language:English
Published: Wiley 2010-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2010/986706
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author Kotaro Terashima
Yoshiyuki Shioyama
Satoshi Nomoto
Saiji Ohga
Takeshi Nonoshita
Kayoko Ohnishi
Kazushige Atsumi
Hidetake Yabuuchi
Hideki Hirata
Hiroshi Honda
author_facet Kotaro Terashima
Yoshiyuki Shioyama
Satoshi Nomoto
Saiji Ohga
Takeshi Nonoshita
Kayoko Ohnishi
Kazushige Atsumi
Hidetake Yabuuchi
Hideki Hirata
Hiroshi Honda
author_sort Kotaro Terashima
collection DOAJ
description We report a case of radiation fibrosis appearing as mass-like consolidation, which was difficult to distinguish from local recurrence. A 72-year-old woman was diagnosed as having primary lung cancer (cT1N0M0 stage IA) in the right upper lobe and was treated with SBRT of 48 Gy in 4 fractions. After 12 months, mass-like consolidation appeared around the irradiated area, and after 13 months, it had increased in size. FDG-PET revealed high uptake (SUV max=5.61) for the consolidation. CT-guided biopsy was performed, but we could not confirm the diagnosis. Considering her poor respiratory function and her age, short-interval follow-up was performed. After 15 months, the consolidation enlarged at the dorsal side, and carcinoembryonic antigen (CEA) became elevated (14.6 ng/mL). Serum KL-6 (436 U/mL) and SP-D (204 ng/mL) were also elevated. However, after 16 months, serum CEA slightly decreased. The consolidation gradually retracted on follow-up CT images. CEA, KL-6, and SP-D were also decreased by degrees. After 40 months, there is no evidence of local recurrence.
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spelling doaj-art-3e0f5cb47e284607b68f0f4e4d1b0ed32025-08-20T02:07:49ZengWileyCase Reports in Medicine1687-96271687-96352010-01-01201010.1155/2010/986706986706A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEAKotaro Terashima0Yoshiyuki Shioyama1Satoshi Nomoto2Saiji Ohga3Takeshi Nonoshita4Kayoko Ohnishi5Kazushige Atsumi6Hidetake Yabuuchi7Hideki Hirata8Hiroshi Honda9Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanDepartment of Radiation Technology, School of Health Sciences, Faculty of Medicine, Kyushu University, Fukuoka 812-8582, JapanDepartment of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, JapanWe report a case of radiation fibrosis appearing as mass-like consolidation, which was difficult to distinguish from local recurrence. A 72-year-old woman was diagnosed as having primary lung cancer (cT1N0M0 stage IA) in the right upper lobe and was treated with SBRT of 48 Gy in 4 fractions. After 12 months, mass-like consolidation appeared around the irradiated area, and after 13 months, it had increased in size. FDG-PET revealed high uptake (SUV max=5.61) for the consolidation. CT-guided biopsy was performed, but we could not confirm the diagnosis. Considering her poor respiratory function and her age, short-interval follow-up was performed. After 15 months, the consolidation enlarged at the dorsal side, and carcinoembryonic antigen (CEA) became elevated (14.6 ng/mL). Serum KL-6 (436 U/mL) and SP-D (204 ng/mL) were also elevated. However, after 16 months, serum CEA slightly decreased. The consolidation gradually retracted on follow-up CT images. CEA, KL-6, and SP-D were also decreased by degrees. After 40 months, there is no evidence of local recurrence.http://dx.doi.org/10.1155/2010/986706
spellingShingle Kotaro Terashima
Yoshiyuki Shioyama
Satoshi Nomoto
Saiji Ohga
Takeshi Nonoshita
Kayoko Ohnishi
Kazushige Atsumi
Hidetake Yabuuchi
Hideki Hirata
Hiroshi Honda
A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA
Case Reports in Medicine
title A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA
title_full A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA
title_fullStr A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA
title_full_unstemmed A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA
title_short A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA
title_sort case of radiation fibrosis appearing as mass like consolidation after sbrt with elevation of serum cea
url http://dx.doi.org/10.1155/2010/986706
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