case_images: PMC10961464_01
case_images: (A, B), Sep. 17, 2020 CT/MR A large irregular mass fused between the gastric cavity, pancreas and spleen, with the largest cross-section measuring approximately 13x16x8cm, it was considered malignant and invaded the splenic hilum, pancreas and local gastric wall. There were intravascular tumor thrombi in the splenic vein and portal vein, multiple nodules in the abdominal cavity, mesentery and greater omentum, suggesting metastasis. (C), before immunotherapy, size of the tumor: 17.8x10cm. (D), after two cycles of immunotherapy, size of the tumor: 11.0x8.2cm. (E), after four cycles of immunotherapy, size of the tumor: 8.0x6.2cm. (F), after six cycles of immunotherapy, size of the tumor: 6.2x4.4cm.
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case_images: A subsequent CT/MR scan (Sep. 17, 2020) disclosed a large irregular mass fused among the gastric cavity, pancreas, and spleen, with its largest cross-section measuring approximately 13x16x8cm (Figure 1). The tumor size decreased progressively and was reduced to 6.2x4.4 cm after six cycles, resulting in a partial response (PR) (Figure 1).
case_images: Timeline.
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case_images: From October 30, 2020, to November 14, 2020, the patient completed two cycles of chemotherapy with "nab-paclitaxel 200 mg d1/14 days repeat" (Figure 2).
case_images: (Left Lower Limb) Systemic subcutaneous soft tissue nodules post-immunotherapy (primarily in the buttocks and lower limbs).
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case_images: Notably, following two cycles of immunotherapy, the patient experienced recurring systemic subcutaneous soft tissue nodules, primarily in the buttocks and lower limbs, which presented with pain and resolved spontaneously (Figures 3 and 4).
case_images: CT Soft tissue nodule of left buttock. (A), after two cycles of immunotherapy, size of soft tissue nodules: 1.9x6.3cm. (B), after four cycles of immunotherapy, size of soft tissue nodules:1.5x6.8cm. (C), after six cycles of immunotherapy, size of soft tissue nodules:1.6x5.8cm.
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case_images: f4
case_images: Notably, following two cycles of immunotherapy, the patient experienced recurring systemic subcutaneous soft tissue nodules, primarily in the buttocks and lower limbs, which presented with pain and resolved spontaneously (Figures 3 and 4).