April 13, 2018


December 2017

  • A 66-year-old Asian woman presents to her PCP complaining of visual disturbances, nausea, fatigue, and sporadic headaches
  • History: HTN, managed on candesartan; hyperlipidemia managed on simvastatin; no smoking history
  • PE: BP, 148/70; LLL auscultation reveals decreased breath sounds
  • CBC: WNL
  • Imaging studies:
    • MRI of the head demonstrated a right parietal mass at the gray—white junction with vasogenic edema
    • CT of chest, abdomen, and pelvis revealed a 3.4-cm mass in the left lower lobe, and several small liver nodules
  • CT-guided transthoracic needle biopsy of the lung lesion showed grade 2 adenocarcinoma, acinar
  • Molecular testing: EGFR exon 19 deletion
  • Staging: T2aN0M1c
  • ECOG 1
  • The patient was started on osimertinib 80 mg once daily