case_images: PMC11233530_01
case_images: The 18F-fluorodeoxyglucose positron emission tomography-computed tomography before initial treatment (A) and after eight cycles of treatments (B).
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case_images: The 18F-fluorodeoxyglucose positron emission tomography-computed tomography (PET/CT) scan from the local hospital showed multiple enlarged inguinal and iliac lymph nodes, suggesting metastasis of malignant neoplasm ( Figure 1A ). On 21 February 2023, this patient underwent a PET/CT scan and the results revealed that there were no tumor lesions in his body ( Figure 1B ).
case_images: (A) Pathology result from scrotal biopsy of this patient; (B) immunohistochemistry staining of human epidermal growth factor receptor 2 protein from scrotal biopsy.
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case_images: The results of pathology consultation were as follows: cytokeratin-7 (+), GATA-3 (+), SOX 10 (-), S-100 (-), MART-1 (-), P63 (-), and Her-2 (++), which confirmed the diagnosis of EMPD ( Figure 2 ).
case_images: Timeline of the major clinical events from diagnosis to the last follow-up.
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case_images: On 26 July 2022, this patient started with disitamab vedotin 120 mg plus serplulimab 200 mg every 2 weeks ( Figure 3 ).
case_images: Enhanced computed tomography for efficacy evaluation (A) before treatment on 29 June 2022, (B) after two cycles of disitamab vedotin plus serplulimab on 7 September 2022, (C) after five cycles of disitamab vedotin maintenance therapy on 27 July 2023, and (D) 9 months after stopping any treatments on 24 March 2024.
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case_images: During this period, enhanced CTs were performed to evaluate the efficacy and results showed that lymph node metastases shrank ( Figure 4 ).