case_images: PMC11260646_01
case_images: CECT and pathological result of the patient before and after surgery. (A) Tumor condition at first CECT scan. (B) The results of pathological biopsy. (C, D) Tumor conditions after six cycles of gemcitabine + capecitabine. CECT, contrast-enhanced computed tomography.
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case_images: Contrast-enhanced computed tomography (CECT) of the abdomen showed an occupying area in the duodenal papilla with gastric retention ( Figure 1A ). The postoperative pathological report confirmed a medium-poorly differentiated adenocarcinoma of the duodenum, classified as the PB type ( Figure 1B ).
case_images: The IHC of the patient's sample. (A) Negative control. (B) Positive control. (C) The test result of the patient. IHC, immunohistochemistry.
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case_images: Furthermore, immunohistochemistry (IHC) demonstrated high expression of PD-L1 (CPS=35, TPS<1%, DAKO 22C3) ( Figures 2A-C ).
case_images: Timeline of the patient's treatment progress.
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case_images: Between February 2023 and July 2023, the patient received six cycles of gemcitabine (1.6g/d, d1, d8, q3w) + S-1 (100mg/d, d1-d14, q3w) + Tislelizumab (200mg/d, d1, q3w) ( Figure 3 ).
case_images: CECT after immunotherapy combined with chemotherapy. (A, B) Tumor condition after six cycles of gemcitabine + S-1 + Tislelizumab in May 2023. (C, D) Tumor condition after six cycles of gemcitabine + S-1 + Tislelizumab in January 2024.
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case_images: As of May 2023, CECT indicated that the patient's tumors shrank 79.5% (from 26.30 cm3 to 5.40 cm3, PR) ( Figures 4A, B ). The latest CECT report in January 2024 showed the patient was in stable condition, which indicated complete response (CR) ( Figures 4C, D ).