case_images: PMC10783890_01
case_images: Timeline of lines of treatment used in this case report of HG-ESS.
case_images: cro-2024-0017-0001-535747_F01.jpg
case_images: PMC10783890_01_cro-2024-0017-0001-535747_F01.jpg
case_images: F1
case_images: Based on the diagnostic, it was decided to start the treatment with adjuvant radiotherapy in the surgical bed (54 Gy, 1.8 Gy/fraction, 28 fractions) and brachytherapy (two applications, 6.6 Gy per application) (Fig. 1).
case_images: a-g Disease progression and changes during treatment. The initial metastatic disease, with hepatic metastasis (18 mm). a Progression 6 month after finishing first-line treatment with epirubicin + ifosfamide. b Hepatic disease before initiating treatment with trabectedin. c Density response observed by image after 19 cycles. Comparative peritoneal disease before (d) and after (e) treatment with erdafitinib. f Response, change in density observed of the main peritoneal implant. g Dimensional response of the implant. Right ureterohydronephrosis. h Stable disease, with reduction of 1 cm, of the radiated implant.
case_images: cro-2024-0017-0001-535747_F02.jpg
case_images: PMC10783890_01_cro-2024-0017-0001-535747_F02.jpg
case_images: F2
case_images: Disease progression to the liver (with peritoneal implants and liver lesions up to 18 mm) was observed and diagnosed during a follow-up in June 2016 (Fig. 2a). However, in March 2018, the patient showed disease progression (Fig. 2b), and the treatment was changed to trabectedin (fourth line). However, in June 2019, the patient had disease progression in the liver (Fig. 2c). After 4 months of treatment, growth of the hepatic lesions (from 118 mm to 132 mm in the major axis) and very striking growth of the peritoneal lesion (56 mm at the beginning of the line to 176 mm) from above 20% was again observed, fulfilling Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 criteria for progression. (Fig. 2d, e). After 6 months of treatment, a reduction of 1 cm in the major lesion and density changes (hypodensity) was observed (Fig. 2f). In April 2022, after 10 months of treatment, an increase of an implant next to the right ureter was observed, with marked ureterohydronephrosis but without repercussions regarding renal function (Fig. 2g). Two months after, a reduction of 1 cm of this lesion was observed together with a global control of the metastatic disease (Fig. 2h).