case_images: PMC11418325_01
case_images: CT scans showing the primary tumor and the liver metastasis. (a) Contrast-enhanced portal phase CT scan showing from left to right: baseline imaging, week 2 post-embolization with extensive tumoral necrosis, and 1-year follow-up after radiotherapy. (b) Contrast-enhanced portal phase CT scan showing from left to right: baseline imaging, 3-month partial response with decreased tumor enhancement.. CT, computed tomography.
case_images: 10.1177_17588359241280541-fig1.jpg
case_images: PMC11418325_01_10.1177_17588359241280541-fig1.jpg
case_images: fig1-17588359241280541
case_images: Abdominal computed tomography scan and magnetic resonance imaging (MRI) showed a pararectal mass of 12 x 9 x 10 cm invading the prostate and right seminal vesicle (Figure 1(a)). After 2 months of treatment with everolimus and 5 months of pembrolizumab, the patient had a nearly complete response on the pelvic tumor (not measurable vs 137 x 95 mm before pembrolizumab) and a 30% decrease in the liver metastasis (Figure 1(a) and (b)).
case_images: Pathological examination of the liver metastasis. (a) Hematoxylin and eosin-stained section showing a high density of epithelioid and clear cells displaying atypia and mitoses. (b) Ki67 staining. (c) PDL1 staining used for the computation of the PDL1 TPS score (50%).. PDL1, programmed death-ligand 1; TPS, tumor positivity score.
case_images: 10.1177_17588359241280541-fig2.jpg
case_images: PMC11418325_01_10.1177_17588359241280541-fig2.jpg
case_images: fig2-17588359241280541
case_images: The diagnosis of malignant PEComa was based on the coexpression of Human Melanoma Black-45 and smooth muscle markers in epithelioid and clear cells, together with atypia, mitoses, and a very high Ki67 index (Figure 2(a) and (b)).