case_images: PMC10866612_01
case_images: Positron emission tomography/CT showed multiple bone metastases of PC (a) and CT showed hepatic cysts in the liver (b), there were no metastases in the liver (c).
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case_images: F1
case_images: Visceral metastases were not observed (Fig. 1).
case_images: Trend graph of tumor markers.
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case_images: PMC10866612_01_cro-2024-0017-0001-536351_F02.jpg
case_images: F2
case_images: However, PSA levels decreased for 7 months, whereas CEA, CA199, and CA125 levels began to increase after 3 months (Fig. 2).
case_images: IHC. a Syn positive [x400]. b Insulinoma-associated protein 1(INSM1) positive [x400]. c PSA negative [x400]. d NSE positive [x400].
case_images: cro-2024-0017-0001-536351_F03.jpg
case_images: PMC10866612_01_cro-2024-0017-0001-536351_F03.jpg
case_images: F3
case_images: CK19 (+). CDX-2 (-), CgA (+), Gly-3 (+), Hepa (-), Ki-67 (+90%), NSE (+), PSA (-), Syn (+), INSM1 (+), TTF-1 (-) (shown in Fig. 3). Considering the poor appetite due to liver metastasis, a reduced dose EP regimen (etoposide 360 mg combined with carboplatin 200 mg) was administered for three cycles.
case_images: a On April 13, 2023, CT showed no metastasis of hepatic cysts. b On June 13, 2023, after the continuous increase of CEA, CA199, and CA125 for 9 months, CT showed diffuse multiple metastases in the liver. c After 3 cycles of etoposide combined with carboplatin chemotherapy, CT reexamination on August 17, 2023, showed that liver metastases were significantly reduced. d Reexamination of CT on September 12, 2023, showed that the liver metastasis increased again and the disease progressed.
case_images: cro-2024-0017-0001-536351_F04.jpg
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case_images: F4
case_images: However, after only 3 months of remission, a reexamination of CT on September 11, 2023, showed that the liver metastasis had increased (Fig. 4).
case_images: Timeline summarizing the main events of this case report.
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case_images: F5
case_images: The patient's family declined further chemotherapy, and he died on November 15, 2023 (Fig. 5).