case_images: PMC11039799_01
case_images: Histology of the tumor tissue (A, B), hematoxylin and eosin, original magnification x200; (C), immunohistochemistry of AE1/AE3, original magnification x100; (D), immunohistochemistry of P40, original magnification x100.
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case_images: PMC11039799_01_fphar-15-1336699-g001.jpg
case_images: F1
case_images: No neuro-vascular involvement was seen (Figure 1). Regular examination showed no abnormalities in routine blood, liver and kidney function, blood sugar, thyroid function, and other indicators (Supplementary Figure S1).
case_images: The case timeline and CT images before and after treatment with sintilimab. (A,B), sintilimab begin; (C,D), 2 cycles after sintilimab treatment; (E,F), 6 cycles after sintilimab treatment; (G,H), 11 cycles after sintilimab treatment; (I,J), 16 cycles after sintilimab treatment; (K,L), 23 cycles after sintilimab treatment; (M,N), 35 cycles after sintilimab treatment; (O,P), 40 cycles after sintilimab treatment.
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case_images: PMC11039799_01_fphar-15-1336699-g002.jpg
case_images: F2
case_images: The new liver parenchyma mass and nodule occupied the space, resulting in intrahepatic bile duct dilatation (Figures 2A,B), and disease progression. On 23 July 2019, the CT scan of the neck, chest, abdomen, and pelvis showed that the mesentery and retroperitoneal lesions were reduced in size, and the liver parenchymal lesions were reduced compared with those on the CT scan from 23 May 2019-DeltaDeltaCT scan (Figures 2C,D). Furthermore, intrahepatic bile duct dilatation was slightly relieved; hilar and retroperitoneal lymph nodes had significantly decreased in size and partially disappeared (Figures 2E,F), and thus the efficacy was evaluated as PR. On 20 May 2020, CT showed that the lesions near the anastomosis, mesentery, and retroperitoneum were smaller than before, and the lesions of the liver parenchyma were smaller (Figures 2G,H). On 22 November 2020, CT examination showed that the nodules in the S8 segment of the liver had shrunk compared with those in previous images, and no significant changes were observed in the remaining segments (Figures 2I,J). On 27 May 2021, CT showed that the low-density shadows in the S8 segment of the liver were slightly smaller than before, and no significant changes were observed in the rest (Figures 2K,L). August 2022, CT showed that the liver metastases almost completely disappeared, and the efficacy evaluation was of complete response (CR) (Figures 2M,N). At the last follow-up on 22 May 2023, CT showed that the metastatic liver lesion had almost completely disappeared, and the efficacy evaluation showed a CR (Figures 2O,P).
case_images: Immunohistochemistry of PD-L1 (22C3) (A), original magnification x100; (B), original magnification x400.
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case_images: PMC11039799_01_fphar-15-1336699-g003.jpg
case_images: F3
case_images: Immunohistochemistry showed that PD-L1 was highly expressed (Figure 3), and the mismatch repair (MMR) status was of proficient mismatch repair (pMMR).