case_images: PMC11390427_01
case_images: Dynamic change process from baseline AFP to September 2023.
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case_images: Subsequent laboratory analysis indicated that the patient tested positive for HBV, and the tumor marker alpha-fetoprotein (AFP) was significantly elevated at 1210 ng/ml ( Figure 1 ).
case_images: CT images showing a large mass in the right lobe of the liver, with the lesion invading the middle hepatic vein, measuring approximately 16.6x8.2 cm in size. (A) Non-enhanced. (B) Enhanced arterial phase. (C, D) Enhanced venous phase.
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case_images: In addition, contrast-enhanced computed tomography (CECT) showed a large mass in the right lobe of the liver (significant enhancement in the arterial phase and rapidly decreasing in enhancement in the venous phase) with multiple satellite foci, which had invaded the middle hepatic vein and was approximately 16.6 x 8.2 cm in size ( Figure 2 ).
case_images: Postoperative CT images. (A-C) After undergoing one cycle of TACE plus Tislelizumab/Lenvatinib, CT showed a reduction in the size of the enhanced extent of the massive lesion in the right lobe of the liver, with an increase in necrotic components compared to before. (D-F) After undergoing two cycles of TACE plus Tislelizumab/Lenvatinib, there was a further increase in the necrotic components within the lesion. (G-I) After undergoing three cycles of TACE plus Tislelizumab/Lenvatinib, the degree of necrosis met the PR criteria of the RECIST standard.
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case_images: Two weeks later, on July 29, 2022, after the operation, subsequent contrast-enhanced computed tomography (CECT) scans showed a decrease in the size of the liver mass and an increase in necrotic components within the lesion ( Figure 3 ). September 6, 2022, the CECT scan revealed uneven lipiodol deposition in the large HCC in the right lobe of the liver, with the lesion showing a decrease in size compared to before, and the enhancement was not obvious ( Figure 3 ). Subsequently, on September 8, 2022, the patient underwent the third TACE. On October 20, 2022, a follow-up CECT scan showed that the HCC lesions did not exhibit enhancement, with large necrotic areas visible during the imaging period ( Figure 3 ).
case_images: (A, B) As of October 2023, CT scan revealed that there has been no tumor recurrence. (C) The patient's treatment process.
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case_images: Follow-up appointments, including hepatic arteriography and CECT or MRI scans, were conducted until October 20, 2023, all of which indicated no tumor recurrence ( Figures 4A, B ). A detailed overview of the patient's treatment process is outlined in  Figure 4C .