case_images: PMC10601644_01
case_images: Immunohistochemical staining of primary tumor: urethral carcinoma. (A) Hematoxylin-eosin staining of urethral carcinoma. Tumor cells were positive for CK5/6 (B), CK7 (C) and GATA-3 (D) and negative for CK20 (E), P63 (F), Uroplakint-2 (G) and Uroplakint-3 (H).
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case_images: PMC10601644_01_fimmu-14-1254812-g001.jpg
case_images: f1
case_images: DX-2 (-), ER (-), PR (-), Uroplakint2 (-), Uroplakin-3 (-), HPV (-) ( Figure 1 ). Due to the low differentiation of tumors, it is difficult to further determine the direction of differentiation.
case_images: Immunohistochemical staining 20X (A), 40X (B) depicted HER2 (1+) in tumor cells.
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case_images: PMC10601644_01_fimmu-14-1254812-g002.jpg
case_images: f2
case_images: A total of five lymph nodes showed cancer metastasis, and the immunohistochemical results were as follows: MLH1 (+), MSH2 (+), MSH6 (+), PMS2 (+), HER2 (1+, referring to the evaluation criteria of breast cancer HER2), Ki-67 (+, 80%) ( Figure 2 ).
case_images: Computed tomography scan before and after Disitamab vedotin combined with toripalimab treatment. (A-E) Lung, pelvic lymph node and left supraclavicular lymph nodemetastases before treatment with Disitamab vedotin in combination with toripalimab. (F-J) All lesions were significantly reduced after 18 cycles of combined treatment. The red arrows indicate the lesions.
case_images: fimmu-14-1254812-g003.jpg
case_images: PMC10601644_01_fimmu-14-1254812-g003.jpg
case_images: f3
case_images: To date, the patient has received Disitamab Vedotin combined with toripalimab 19 cycles and had an ongoing response for more than 12 months ( Figure 3 ).
case_images: Timeline scheme of major clinical event of the patient since diagnosis.
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case_images: PMC10601644_01_fimmu-14-1254812-g004.jpg
case_images: f4
case_images: The patient's treatment process is shown in  Figure 4 .