case_images: PMC11783290_01
case_images: Computed tomography abdomen (venous phase) at diagnosis (A, B) and after 4 cycles of chemotherapy (C, D). (A) Arrow = pancreatic head mass. (B) Innumerable hypoattenuating hepatic lesions with peripheral enhancement. (C) Arrow = pancreatic head mass. (D) Marked improvement in liver metastasis.
case_images: oyae034_fig1.jpg
case_images: PMC11783290_01_oyae034_fig1.jpg
case_images: F1
case_images: Computerized tomography (CT) of the abdomen demonstrated a 3.5-cm ill-defined mass in the pancreatic head with pancreatic duct dilation and innumerable, bilobar masses throughout the liver parenchyma, the largest lesions measuring 3.6 cm and 3.1 cm in the left and right lobes, respectively (Figure 1).
case_images: Computed tomography abdomen (arterial phase) before (A, B) and after 2 months of selpercatinib (C, D). (A) Arrow = pancreatic head mass. (B) Arrow = anterior left hepatic lobe mass. (C) arrow = pancreatic head mass. (D) anterior left hepatic lobe mass largely resolved. Arrow, new hypoattenuating lesion.
case_images: oyae034_fig2.jpg
case_images: PMC11783290_01_oyae034_fig2.jpg
case_images: F2
case_images: Patient's first restaging imaging (Fig. 2) was 55 days after starting therapy and showed progressive disease by RECIST v1.1 with a 79% increase in target lesions and new hepatic metastases.