case_images: PMC7154275_01
case_images: a, b Abdominal contrast-enhanced CT findings before chemotherapy with cytotoxic and molecular targeted drugs. Low-density areas (white arrows) suspected of being peritoneal dissemination were detected.
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case_images: F1
case_images: Then, 1.5 years after the hepatectomy, peritoneal metastases were detected by abdominal contrast-enhanced CT (Fig. 1).
case_images: a, b Abdominal contrast-enhanced CT findings after 5 cycles of chemotherapy with cytotoxic and molecular targeted drugs. The size of peritoneal dissemination (white arrows) had increased.
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case_images: F2
case_images: However, as her disease progressed despite these treatments (Fig. 2), she was started on pembrolizumab at 200 mg because the primary resected specimen revealed that the tumor was MSI-high.
case_images: Head MRI findings. There was no tumor in the pituitary gland (white arrow).
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case_images: F3
case_images: The magnetic resonance imaging (MRI) findings revealed no remarkable findings in the pituitary gland or hypothalamus (Fig. 3).
case_images: a, b Abdominal contrast-enhanced CT findings after 5 cycles of chemotherapy with pembrolizumab. The size of peritoneal dissemination (white arrows) was unchanged.
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case_images: F4
case_images: After 5 cycles of pembrolizumab, carcinoembryonic antigen levels were within the normal range, and CT showed that the size of the peritoneal dissemination had progressed slightly (Fig. 4).