case_images: PMC11808132_01
case_images: Imaging findings of CT, MRI, pathology and endoscopy. GEJ mass [(A) 0 month, (H) 6 months, (J) 12 months)], (B-D) liver metastasis and enlarged lymph nodes in CT imaging, (E) liver metastasis in MRI imaging, (F) pathologic findings of GEJ mass (HE staining x 100), (G) pathologic findings of liver metastasis (HE staining x 100), (I) CT scan in 6 months, (K) CT scan in 12 months.
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case_images: An upper gastrointestinal endoscopy demonstrated a small intraluminal mass at the GEJ ( Figure 1A ), and a biopsy was conducted for pathology. Abdominal CT and MRI scans showed a metastatic lesion in liver segment VIII, as well as enlarged perigastric and retroperitoneal lymph nodes ( Figures 1B-E ). HE staining and immunohistochemical (IHC) analysis suggested GEJ HAC with liver metastasis ( Figures 1G ,  2 ,  3 ). Figure 4 ), and the metastatic lesion in liver segment VIII significantly shrunk ( Figures 1I, K ). From December 8, 2023, to July 7, 2024, a wait-and-watch strategy was adopted.
case_images: Immunohistochemistry results of mass at GEJ. (A) AFP positive (IHC [EnVision] 100x), (B) Arginase-1 negative (IHC [EnVision] 100x), (C) CA199 positive (IHC [EnVision] 100x), (D) CD10 negative (IHC [EnVision] 100x), (E) CK7 positive (IHC [EnVision] 100x), (F) CK19 positive (IHC [EnVision] 100x), (G) CK20 positive (IHC [EnVision] 100x), (H) Glypican-3 positive (IHC [EnVision] 100x), (I) HepPar-1 positive (IHC [EnVision] 100x), (J) Her-2 negative (IHC [EnVision] 100x), (K) MUC-1 positive (IHC [EnVision] 100x), (L) P53(wild type)positive (IHC [EnVision] 100x).
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case_images: HE staining and immunohistochemical (IHC) analysis suggested GEJ HAC with liver metastasis ( Figures 1G ,  2 ,  3 ).
case_images: Immunohistochemistry results of metastatic liver tissue (A) AFP positive (IHC [EnVision] 100x) (B) CD10 positive (IHC [EnVision] 100x) (C) CK7 negative (IHC [EnVision] 100x) (D) CK19 positive (IHC [EnVision] 100x) (E) CK20 positive (IHC [EnVision] 100x) (F) HepPar-1 positive (IHC [EnVision] 100x) (G) MUC-1 positive (IHC [EnVision] 100x) (H) P53 (wild type) positive (IHC [EnVision] 100x) (I) ki67 positive (IHC [EnVision] 100x).
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case_images: HE staining and immunohistochemical (IHC) analysis suggested GEJ HAC with liver metastasis ( Figures 1G ,  2 ,  3 ).
case_images: Changes in serum levels of AFP (A), CA 19-9, CEA (B); AFP, alfa-fetoprotein, CEA, carcinoembryonic antigen; CA 19-9, carbohydrate antigen 19-9.
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case_images: Figure 4 ), and the metastatic lesion in liver segment VIII significantly shrunk ( Figures 1I, K ). From December 8, 2023, to July 7, 2024, a wait-and-watch strategy was adopted.
case_images: Timeline of the case report. SOX, oxaliplatin and S-1; AFP, alfa-fetoprotein; CEA, carcinoembryonic antigen; CA 19-9, carbohydrate antigen 19-9; MPR, major pathologic response; PFS, progression-free; RECIST, Response Evaluation Criteria in Solid Tumours.
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case_images: f5