case_images: PMC11349563_01
case_images: Clinical images of hepatocellular carcinoma in a 64-year-old man. (A) Advanced CT imaging has detected a significant mass in the right hepatic lobe, spanning multiple segments with dimensions of 112 mm x 77 mm x 83 mm. (B) Advanced CT imaging has identified a tumor in the right lobe of the liver with dimensions of 75 mm by 67 mm by 67 mm. Following completion of TACE, the efficacy of the treatment is PR in accordance mRECIST. (C) MRI revealed the largest hepatic tumor measuring approximately 69 mm x 63 mm x 67 mm. The efficacy of the radiotherapy has been evaluated as PR.
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case_images: A follow-up CT scan conducted one month post-radiotherapy demonstrated continued partial response (PR) to treatment ( Figures 1A-C ).
case_images: Timeline of the clinical course. TACE, transcatheter arterial chemoembolization; iv.gtt., intravenous drip; po., per os.
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case_images: Following six cycles of immune checkpoint inhibitor (ICI) therapy, the patient developed diarrhea, with episodes up to four times daily.  Figure 2  provides a comprehensive illustration of the patient's detailed treatment process.This was managed with montmorillonite powder for toxin absorption and loperamide to regulate bowel movements.
case_images: Clinical images during the treatment. (A) Plain abdominal x-ray shows no evidence of bowel distension or free intraperitoneal gas, but revealed increased colonic content and mild dilatation at the hepatic flexure of the right colon, along with gas-fluid levels. (B) Gastroscopy demonstrated features of chronic non-atrophic gastritis, with congested and edematous gastric folds, multiple ulcerative scars in the antrum, and flaky congestion in the duodenal papilla. (C) Pathological examination confirmed mild chronic mucosal inflammation with interstitial vascular congestion and a minor eosinophilic infiltrate. (D) Colonoscopy revealed congestion and edema of the colorectal mucosa, indistinct vascular patterns, friable mucosa prone to contact bleeding, and superficial erosions and ulcerations, leading to a diagnosis of colitis. (E) The pathology indicates a moderate level of chronic inflammation in the mucosa, with the presence of cryptitis and crypt abscesses. (F) Abdominal and pelvic scans revealed colonic dilation with fluid and gas accumulation.
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case_images: Abdominal radiography showed no evidence of bowel distension or free intraperitoneal gas, but revealed increased colonic content and mild dilatation at the hepatic flexure of the right colon, along with gas-fluid levels ( Figure 3A ). Gastroscopy demonstrated features of chronic non-atrophic gastritis ( Figure 3B ). Pathological examination confirmed mild chronic mucosal inflammation with interstitial vascular congestion and a minor eosinophilic infiltrate ( Figure 3C ). Colonoscopy revealed the presence of colitis ( Figure 3D ). Figure 3E ). Further imaging with abdominal and pelvic scans showed colonic dilation with fluid and gas, but no intraluminal stenosis, suggesting functional obstruction or inflammatory disease without mechanical blockage ( Figure 3F ).