case_images: PMC10824524_01
case_images: Baseline evaluation after target therapy. Volumetric CT MPR images in the axial (a-c) and coronal (d) planes after intravenous contrast media administration. a There is a metastasis (black arrow) in the posterior segment of the upper lobe of the right lung. Multiple metastatic implants on the peritoneal surface (white arrows) ranging in size from a few millimeters to masses (b, c). The omentum, located anteriorly and to the left of the midline, appears stranded and bulky from confluent nodules (asterisk). Coronal image (d) shows confluent metastatic sites at the level of the omentum (left abdominal quadrants) and a small amount of peritoneal effusion in the pelvis.
case_images: cro-2024-0017-0001-535902_F01.jpg
case_images: PMC10824524_01_cro-2024-0017-0001-535902_F01.jpg
case_images: F1
case_images: A CT scan after 3 months showed a clear progression of abdominal carcinomatosis (as shown in Fig. 1), consistent with the rapid worsening of clinical conditions.
case_images: First CT control 2 months after the start of immunotherapy. Volumetric CT MPR images in the axial (a-d) planes after intravenous contrast media administration. a Reduction in size of lung metastasis appearing as a ground-glass band (black arrow) in the posterior segment of the upper lobe of the right lung. b-d Reduction in size and density of peritoneal nodules (white arrows) and omental masses with initial restoration of fat density between confluent nodules (asterisk).
case_images: cro-2024-0017-0001-535902_F02.jpg
case_images: PMC10824524_01_cro-2024-0017-0001-535902_F02.jpg
case_images: F2
case_images: After only 1 cycle, the patient experienced a progressive clinical benefit and the CT scan performed in July 2022 demonstrated a partial response >90% both at the pulmonary and abdominal levels, as shown in Figure 2.
case_images: Third CT control 10 months after the start of immunotherapy. Volumetric CT MPR images in the axial (a-c) and coronal (d) planes after intravenous contrast media administration. a The pulmonary metastasis is no longer visible in the posterior segment of the upper lobe of the right lung. b-d Further reduction in size of peritoneal nodules (arrowhead) and omental masses are no longer present but only small and isolated nodules (white arrows) with restoration of omental and mesenteric fat density.
case_images: cro-2024-0017-0001-535902_F03.jpg
case_images: PMC10824524_01_cro-2024-0017-0001-535902_F03.jpg
case_images: F3
case_images: The patient is currently in excellent clinical condition and the last CT evaluation in March 2023 showed a complete pulmonary response, as well as further dimensional reduction of the peritoneal nodules, as shown in Figure 3.