case_images: PMC11775007_01
case_images: Timeline, enhanced computed tomography (CT) scan at the time of diagnosis and liver puncture pathological findings. (A) Showing the course of initial diagnosis, medication, and surgery. (B) Showing a large hypodense mass about 8.3*6.4cm size in the right lobe of the liver. (C) Liver puncture pathology was suggestive of poorly differentiated adenocarcinoma with necrosis.
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case_images: f1
case_images: An upper abdominal enhanced computed tomography (CT) scan showed a slightly lower density of a circular lesion of about 8.3*6.4cm in the right lobe of the liver ( Figure 1B ). Results of ultrasound-guided liver tissue puncture of the patient were considered to be poorly differentiated adenocarcinoma with necrosis ( Figure 1C ).
case_images: Results of changes in tumor markers of the patient during systemic treatment. Showing ratios to normal limits, including the alpha-fetoprotein (AFP) levels, the carcinoembryonic antigen (CEA) levels, the cancer antigen 19-9 (CA19-9) levels and the cancer antigen 125 (CA125) levels.
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case_images: PMC11775007_01_fonc-14-1476593-g002.jpg
case_images: f2
case_images: Respectively, the cancer antigen 125 level exceeded 1000 ng/ml; the carcinoembryonic antigen level was 13.67 ng/ml; the cancer antigen 19-9 level was 50.2 units/ml; the alpha-fetoprotein level and DCP (Des-gamma-Carboxy Prothrombin) level were within normal limits ( Figure 2 ).
case_images: Imaging review results of the patient during systemic therapy. (A) Showing enhanced CT results of 2023-08-19, before the third cycle. (B) Showing magnetic resonance imaging and cholangiopancreatography results of 2023-10-21, before the sixth cycle. (C) Showing enhanced CT of 2023-11-14, after 6 cycles with a reduction in the longest diameter of the tumor to 4.9cm. (D) Display the results of the enhanced CT scans of the two postoperative reviews.
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case_images: PMC11775007_01_fonc-14-1476593-g003.jpg
case_images: f3
case_images: Tegafur (60 mg qm, 40mg qn, d1 to d14), and Zimberelimab (240 mg, q21 days), enhanced CT scans showed a reduction in the maximum tumor diameter from 8.3cm to 4.9cm ( Figures 3A-C ). The patient was re-examined by CT on the 5th and 13th day after surgery ( Figure 3D ), which showed the operative area recovered well with no residual lesions.