case_images: PMC10665906_01
case_images: Computed tomography images before the initiation of enfortumab vedotin therapy. (A) Recurrent tumor in the pelvic cavity suspected to invade the sigmoid colon and rectum. (B) Multiple metastases in both lungs. Computed tomography images after the second course of enfortumab vedotin therapy. (C) Recurrent tumor in pelvic cavity has dramatically shrunk. (D) Multiple lung metastases have disappeared.
case_images: fonc-13-1274494-g001.jpg
case_images: PMC10665906_01_fonc-13-1274494-g001.jpg
case_images: f1
case_images: Computed tomography (CT) scan obtained before EV initiation revealed a recurrent tumor invading the sigmoid colon and rectum and multiple lung metastases in bilateral lungs ( Figures 1A, B ). CDx (Foundatione Medicine, USA) ( Table 1 ). CT scan after the second EV course revealed the disappearance of multiple lung metastases and dramatic shrinkage of the recurrent tumor in the pelvic cavity ( Figures 1C, D ). On the contrary, the surgical specimens included few CD4+ and CD8+ cells, no CD20+ cells, and were negative for PD-L1 expression ( Supplemental Figures 1A-D ).
case_images: (A) Colonoscopy image showing a fistula in the lateral rectal wall. (B) Contrast enema image showing inflow of the contrast agent into the sigmoid colon through the rectum.
case_images: fonc-13-1274494-g002.jpg
case_images: PMC10665906_01_fonc-13-1274494-g002.jpg
case_images: f2
case_images: Figure 2A ). Furthermore, contrast enema revealed the inflow of the contrast agent into the sigmoid colon through the rectum, confirming the formation of a fistula through the tumor cavity ( Figure 2B ).
case_images: Immunohistochemical staining demonstrates increased nectin-4expression in the tumor region of initial surgical specimens. Magnification, 40x (A) and 100x (B).
case_images: fonc-13-1274494-g003.jpg
case_images: PMC10665906_01_fonc-13-1274494-g003.jpg
case_images: f3
case_images: As shown in  Figures 3A, B , nectin-4 was highly expressed in tumor cells.