case_images: PMC10498115_01
case_images: Comparison of enhanced CT prior to (June, 2019) and after (December, 2019) first-line treatment. (A) Before the administration of TCbH, abnormal small nodular signals were observed in the right lobe of the liver, which was 16 mm in diameter. (B) After 5 cycles of TCbH, shrinkage of the liver metastasis was observed; the diameter of the lesion was 6 mm.
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case_images: PMC10498115_01_fonc-13-1245701-g001.jpg
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case_images: Despite substantial primary tumor and brain metastases growth and extensive tumor burden, the metastatic lesions in the liver gradually shrank and disappeared ( Figure 1B ).
case_images: Comparison of brain MRI prior to (February, 2022) and after (September, 2022) forth-line treatment. (A) Before the administration RC48 plus bevacizumab, multiple brain metastases in the bilateral cerebellar hemispheres, the right parietal lobe and the left fronto-temporo-parieto-occipital lobe were observed, with obviously annular and nodular enhancement, the larger of which measured 2.6 x 2.5 cm2. (B) After 4 cycles, shrinkage of the brain metastases was observed, the larger of which measured 1.5 x 1.3 cm2, with diminished enhancement of some lesions. (C) After 7 cycles, further shrinkage of the brain metastases was observed. (D) After 13 cycles, MRI showed the volume of some brain metastatic sites increased with marked annular and nodular enhancement, the larger of which measured 1.7 x 1.3 cm2, which suggested local progression of tumor.
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case_images: PMC10498115_01_fonc-13-1245701-g002.jpg
case_images: f2
case_images: In February 2022, MRI showed that the brain metastases were enlarged ( Figure 2A ), representing tumor progression. Notably, within two months, a reduction in size was observed on MRI scans, transitioning from 2.6 x 2.5 cm2 to 1.5 x 1.3 cm2 within the right parietal lobe ( Figure 2B ). As of June 28, 2022, the MRI demonstrated a further decrease in the dimensions of residual lesions ( Figure 2C ). At the time of writing, due to the re-progression of brain metastases ( Figure 2D ), the patient was treated with RC48 combined with bevacizumab and pyrotinib.