case_images: PMC8637399_01
case_images: CT images of the tumor.. Plain computed tomography (A) demonstrated a low-density tumor (54 mm in diameter) in the liver S8. The tumor was (B) enhanced in the arterial phase and (C) washed out in the equilibrium phase.. Abbreviation: CT, computed tomography.
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case_images: A, and laboratory evaluation showed elevated tumor markers: alpha-fetoprotein, 22,882 ng/mL; and protein induced by vitamin K absence/antagonist II, 4793.3 mAU/mL. A dynamic computed tomography (CT) scan of the abdomen revealed a round-shaped and hypodense S8 tumor measuring 54 mm in diameter, which was enhanced in the arterial phase and washed out in the portal venous and delayed phases (Figure 1).
case_images: CT scans over the course of treatment with atezolizumab plus bevacizumab.. The upper panels show the right lung and the lower panels show the left ilium. (A) CT images before the initiation of treatment showing metastatic tumors (arrows). (B) CT image after the second course showing an increase in the size of the tumors (arrows). (C) CT image after the third course showing a decrease in size of the tumor (arrows). (D) CT images after the fourth course showing disappearance of the right lung tumor and a decrease in the left iliac tumor (arrows). (E) No recurrence of metastatic lung tumors, and further reduction in the left iliac tumor after the fifth course (arrows).. Abbreviation: CT, computed tomography.
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case_images: TACE twice; however, the metastatic lesions of the left iliac increased, and bilateral lung and pelvic lymph node metastases were newly observed (Figure 2A). Therefore, the administration of atezolizumab plus bevacizumab was initiated 5 months after the initial treatment. After the administration of the second course of atezolizumab plus bevacizumab, the CT scan showed growth in the lung tumor, left iliac tumor, and pelvic lymph node tumor (Figure 2B). After administration of the third course of atezolizumab plus bevacizumab, the CT scan showed a decrease in both lung and iliac tumors (Figure 2C), and after administration of the fourth course of atezolizumab plus bevacizumab, the CT scan showed disappearance of the lung tumor (Figure 2D). After administration of the fifth course of atezolizumab plus bevacizumab, the CT scan showed no recurrence of the lung tumor and further reduction of iliac and pelvic lymph node metastases (Figure 2E), indicating a partial response.
case_images: Clinical course of tumor markers.
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case_images: Elevated levels of tumor markers were also observed (Figure 3). Along with the reduction of the tumor, a decrease in tumor marker levels was also observed (Figure 3).