case_images: PMC11409080_01
case_images: Imageological examination. (A) Abdominal enhanced CT at first admission: The local wall of the sigmoid colon shows circumferential thickening with mild enhancement, resulting in a narrow lumen and roughness around the wall. Consider sigmoid colon cancer, preliminary staging T4N1. (B) MR rectal scan after 3 months of PDT: The image shows a metallic internal fixator within the lumen of the sigmoid colon, with corresponding mild thickening of the intestinal wall. The proximal and distal ends of the stent exhibit uneven thickening of the intestinal wall that protrudes into the lumen. (C) MR rectal scan 4.5 months after PDT: Within the lumen of the sigmoid colon, a metallic internal fixator shadow is visible. Mild thickening of the bowel wall where the stent is located, uneven thickening of the bowel wall proximal and distal to the stent and protruding into the lumen, proximal luminal stenosis slightly better than before. (D) Abdominal CT 6 months after photodynamic surgery: After colonic stent placement, thickening of the wall and grossness of the tube is seen. (E) MR Rectal plain scan 6 months after photodynamic operation: Changes after colonic stent placement, uneven thickening of the proximal and distal bowel wall of the stent and protruding into the lumen, this time the proximal and distal bowel wall of the stent thickened to a lesser extent. (F) Abdominal CT 2 months after robotic surgery: No obvious abnormal thickening of the anastomotic wall after radical surgery for colon cancer. (G) Abdominal CT 5 months after robotic surgery: After radical resection of colon cancer, the anastomotic wall does not thicken. The red arrows demonstrate the site of the tumor lesion, the location of the metal stent, and the postoperative anastomosis.
case_images: fimmu-15-1403613-g001.jpg
case_images: PMC11409080_01_fimmu-15-1403613-g001.jpg
case_images: f1
case_images: The enhanced Computed Tomography (CT) examination of abdomen showed: sigmoid colon cancer, preliminary stage T4N1 ( Figure 1 ). The lesion exhibited a firm texture with a constrictive growth pattern and surface ulceration ( Supplementary Figure 1 ). Following PDT, the colonoscopy re-examination conducted on March 1, 2023 revealed unobstructed lumen and significant regression of the lesion ( Supplementary Figure 1 ). The number of enlarged lymph nodes adjacent to the bilateral iliac vessels and inguinal region decreased compared to before treatment ( Figure 1 ). A CT scan of the abdomen conducted one month post-surgery revealed no significant abnormal thickening at the anastomotic site ( Figure 1 ).
case_images: Pathologic biopsy results. (A) The hematoxylin-eosin (H&E) staining: A small amount of residual well-differentiated adenocarcinoma component in the ulcerative lesion area, with cancer invasion into the subserosal layer (pT3), without definite involvement of blood vessels or nerves; tumor regression grade (TRG): Grade 1 (single or small foci of residual cells); no cancer invasion in the resected margins on both sides. (B) Immunohistochemical staining: there was no lymph node metastasis (0/24); immunohistochemistry staining results: cancer cells CK8/18+,Syn-, CgA-, p53 (+), C-erbB-2 (0), Ki67 (40%+); MLH1+, PMS-2+, MSH-2+, MSH-6+.
case_images: fimmu-15-1403613-g002.jpg
case_images: PMC11409080_01_fimmu-15-1403613-g002.jpg
case_images: f2
case_images: The pathological examination results revealed the presence of moderately differentiated adenocarcinoma in the colon ( Figure 2 ). A small amount of residual well-differentiated adenocarcinoma component in the ulcerative lesion area, with cancer invasion into the subserosal layer (pT3), without definite involvement of blood vessels or nerves; tumor regression grade (TRG): Grade 1 (single or small foci of residual cells) ( Figure 2 ); no cancer invasion in the resected margins on both sides. 2.
case_images: Treatment flow chart.
case_images: fimmu-15-1403613-g003.jpg
case_images: PMC11409080_01_fimmu-15-1403613-g003.jpg
case_images: f3
case_images: Following PDT, patients underwent a 4-cycle chemotherapy regimen consisting of "Oxaliplatin + Capecitabine", in conjunction with targeted and immunotherapy utilizing "Bevacizumab + Sintilimab"( Figure 3 ).
case_images: Laboratory test results during treatment. (A) Trends in the level of tumor markers, including AFP, CEA, CA 199 and CA125. (B) Trends in the level of blood routine examination, including PLT, HB, and WBC. (C) Trends in the level of biochemical indicators, including ALT, AST, and T-BIL. (D) Trends in the level of weight changes.
case_images: fimmu-15-1403613-g004.jpg
case_images: PMC11409080_01_fimmu-15-1403613-g004.jpg
case_images: f4
case_images: Laboratory test indicators are better than before ( Figure 4 ).