case_images: PMC10185440_01
case_images: Basal CT scan. Multiple and bilobar hepatic metastases are observed
case_images: etat-04-1002136-g001.jpg
case_images: PMC10185440_01_etat-04-1002136-g001.jpg
case_images: F1
case_images: Abdominal ultrasounds showed liver lesions and the computerized tomography (CT) thoracoabdominal-pelvic scan showed an irregular thickening of the cecum wall with locoregional adenopathies in both the hepatic hilum and in the gastroduodenal ligament and multiple hepatic metastases (Figure 1).
case_images: Urgent CT scan showed pseudonodular hypodense image depending on the lateral wall of the second duodenal portion (blue arrow) that causes distension of the gastric chamber
case_images: etat-04-1002136-g002.jpg
case_images: PMC10185440_01_etat-04-1002136-g002.jpg
case_images: F2
case_images: CT scan showed distension of the gastric chamber and, more strikingly, of the first and second duodenal portion with abundant content, with a pseudonodular hypodense image depending on the lateral wall of the second duodenal portion, in addition to bilateral pulmonary thromboembolism and a single pulmonary metastasis in the right lower lobe of 9 mm (Figure 2).
case_images: CT prior to the start of treatment with TAS-102. Pulmonary metastasis (blue arrow) and retroperitoneal lymph node involvement are observed. Complete hepatic response is maintained. R: right side of the patient
case_images: etat-04-1002136-g003.jpg
case_images: PMC10185440_01_etat-04-1002136-g003.jpg
case_images: F3
case_images: CT after 3 cycles of TAS-102. Complete response of pulmonary metastasis and retroperitoneal lymph node involvement was observed (blue arrows)
case_images: etat-04-1002136-g004.jpg
case_images: PMC10185440_01_etat-04-1002136-g004.jpg
case_images: F4
case_images: After the third cycle, a complete response of lymph node involvement and pulmonary metastasis response was observed (Figure 4).
case_images: PET/CT showing no pathological uptake of 18-fluoro-deoxy-glucose. Complete biometabolic response is confirmed. Left of the figure is the corresponding CT image. Right of the figure is the image corresponding to the PET, with absence of pathologi-cal uptake
case_images: etat-04-1002136-g005.jpg
case_images: PMC10185440_01_etat-04-1002136-g005.jpg
case_images: F5
case_images: A positron emission tomography-CT (PET-CT) scan (Figure 5) and colonoscopy performed at this time revealed the absence of disease, accompanied by a biochemical response with the tumor marker carcinoembryonic antigen decreased to less than 0.5 mug/L.