case_images: PMC9520138_01
case_images: The histologic examination revealed a solid tumor mass with pleomorphic cells and a moderate desmoplastic stromal reaction (a: HE) and some cells with intracellular mucin deposits (b: PAS) (100 microm). Immunohistochemistry showed a focal reaction for cytokeratin 7 (c) and a strong proliferative activity for Ki67 (d) (100 microm). The staining for HER-2 was only weakly present in the tumor cells (e) and no staining could be seen for PD-L1 (f) (100 microm).. HE, hematoxylin and eosin; HER-2, human epidermal growth factor receptor 2; PAS, periodic acid Schiff; PD-L1, programmed death-ligand 1.
case_images: 10.1177_17588359221125096-fig4.jpg
case_images: PMC9520138_01_10.1177_17588359221125096-fig4.jpg
case_images: fig4-17588359221125096
case_images: Table 1. The results of the histologic examination are shown in Figure 4.
case_images: MRI scan on the left side shows the diffuse lesion expansion after the fifth cycle of first-line chemotherapy. The scan on the right side shows the response after 3 months in which the patient is in complete remission.. MRI, magnetic resonance imaging.
case_images: 10.1177_17588359221125096-fig5.jpg
case_images: PMC9520138_01_10.1177_17588359221125096-fig5.jpg
case_images: fig5-17588359221125096
case_images: A 74-year-old male was diagnosed with an advanced iCC of both liver lobes and pulmonary metastases (Figures 5 and 6). The treatment outcome was evaluated by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) before pemigatinib administration and after 3 months (Figures 5 and 6). In the pre- and post-MRI image data, an interactive tumor delineation method previously applied to liver CT data was used to determine the change in tumor size.   The images show a significant decrease in the tumor lesion volume from 453.9 to 133.7 ml after 3 months of treatment (Figure 5).
case_images: Display of complete metabolic remission 3 months after initiation of pemigatinib. Shown are MIPs (outer columns), transaxial slices of CT (inner upper column) as well as fused PET/CT (inner lower column). The patient initially presented with multiple pulmonary as well as hepatic metastases. The follow-up imaging revealed complete metabolic resolution of all lesions.. CT, computed tomography; MIPs, maximum intensity projections; PET, positron emission tomography.
case_images: 10.1177_17588359221125096-fig6.jpg
case_images: PMC9520138_01_10.1177_17588359221125096-fig6.jpg
case_images: fig6-17588359221125096
case_images: A 74-year-old male was diagnosed with an advanced iCC of both liver lobes and pulmonary metastases (Figures 5 and 6). The treatment outcome was evaluated by magnetic resonance imaging (MRI) and fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) before pemigatinib administration and after 3 months (Figures 5 and 6). The FDG-PET/CT revealed a complete functional remission of the iCC and lung metastases after 3 months of treatment (Figure 6).
case_images: Development of tumor markers during the clinical course and treatment. During therapy with pemigatinib, a significant decrease in the CA19-9 and CEA was observed resulting in a plateau representing complete remission.. CA, carbohydrate antigen; CEA, carcinoembryonic antigen.
case_images: 10.1177_17588359221125096-fig7.jpg
case_images: PMC9520138_01_10.1177_17588359221125096-fig7.jpg
case_images: fig7-17588359221125096
case_images: Over the course of the treatment, tumor markers that were elevated at baseline measurement decreased to a plateau (Figure 7).