Postoperative EGFR-TKI treatment on residual multiple ground-glass nodules after resection for lung adenocarcinoma:a case report and literature review

Abstract

Background: Multiple ground-glass nodules (mGGNs) in the lung has been defined as synchronous multiple primary lung cancer (SMPLC), it is very difficult to differentiate SMPLC from intrapulmonary metastases, and the treatment is still controversial. Case presentation: We report a case of mGGNs simultaneously with lung adenocarcinoma harboring primary EGFR-T790M mutation, in which the patient underwent radical resection of lesions in the left upper lung, and continued osimertinib treatment for the residual mGGNs in all lobes of the right lung. The mGGNs in the right lung displayed different responses to osimertinib. Conclusions: We report a successful strategy on the postoperative treatment for mGGNs. For mGGNs that cannot be completely resected, chemotherapy, radiotherapy, stereotactic body radiation therapy (SBRT) ,immunotherapy and targeted therapy have been tried. EGFR-TKI therapy strategy shows obvious advantages, but how to achieve better therapeutic effect that needs more researches.