case_images: PMC11405160_01
case_images: (A) CT revealed multiple small nodules (red arrow) and effusion (blue circle) in the abdominal cavity; (B) CT showed uneven pelvic floor peritoneum, nodular thickening, and obvious enhancement (red arrow); (C) Magnetic resonance imaging showed that the omentum changed in cake shape (red arrow); (D) Magnetic resonance imaging showed uterine (red arrow) and fallopian tube (blue arrow) involvement. (E) CT showed the peritoneal nodules disappeared and no obvious enhancement was observed; (F) CT showed that the small tubercles in the abdominal cavity were significantly reduced and the abdominal effusion had disappeared.
case_images: fonc-14-1428918-g001.jpg
case_images: PMC11405160_01_fonc-14-1428918-g001.jpg
case_images: f1
case_images: Computed tomography (CT) revealed multiple small nodules and effusion in the abdominal cavity ( Figure 1A ), with an uneven pelvic floor peritoneum, nodular thickening, and obvious enhancement ( Figure 1B ). Magnetic resonance imaging showed an omental cake ( Figure 1C ) and uterine and fallopian tube involvement ( Figure 1D ). Follow-up CT examination showed that the peritoneal nodules had disappeared, and no obvious enhancement was observed on 2023-08-02 ( Figure 1E ). The CT examination also showed that the small tubercles in the abdominal cavity were significantly reduced, and the abdominal effusion had disappeared ( Figure 1F ).
case_images: (A) Bloody ascites; (B) Cytological examination of ascites showed multiple clusters of adenocarcinoma cells.
case_images: fonc-14-1428918-g002.jpg
case_images: PMC11405160_01_fonc-14-1428918-g002.jpg
case_images: f2
case_images: The ascites was bloody ( Figure 2A ), and cytological examination of the ascites showed multiple clusters of adenocarcinoma cells ( Figure 2B ).
case_images: (A) Multiple nodules were observed in the greater omental tissue of the abdominal cavity. (B) Microscopy revealed epithelial tumors with necrosis and large amounts of sand-like calcification; (C) Tumor cell nuclei displayed marked pleomorphism and membrane irregularities; (D) One tumor involved the surface of the left ovary; (E) Another tumor involved the surface of the right ovary; (F-H) The expression of CA125, ER and Pax 8 markers was strongly positive; (I) The expression of calretinin was negative.
case_images: fonc-14-1428918-g003.jpg
case_images: PMC11405160_01_fonc-14-1428918-g003.jpg
case_images: f3
case_images: Multiple nodules were observed in the greater omental tissue of the abdominal cavity ( Figure 3A ). Microscopy revealed epithelial tumors with necrosis and large amounts of sand-like calcifications ( Figure 3B ). Tumor cell nuclei displayed marked pleomorphism and membrane irregularities ( Figure 3C ). One tumor involved the surface of the left ovary ( Figure 3D ). Another tumor involved the surface of the right ovary ( Figure 3E ). The expression of CA125, ER and Pax 8 markers was strongly positive ( Figures 3F-H ), whereas that of calretinin was negative ( Figure 3I ).
case_images: NGS showed BRCA2 mutation.
case_images: fonc-14-1428918-g004.jpg
case_images: PMC11405160_01_fonc-14-1428918-g004.jpg
case_images: f4
case_images: BRCA gene mutation detection and had a homologous recombination deficiency score of 25 for BRCA2 (reference value: 42) ( Figure 4 ). Based on these results, the patient was considered sensitive to olapalil.