case_images: PMC11027594_01
case_images: (a) The aspect of adenocarcinoma consists of glandular structures lined with cubic single-layer epithelial cells. (b and c) Tumor cells showed both CK 19 (b) and CK 7 (c) immunohistochemistry positivity.
case_images: 10.1177_17588359241247023-fig3.jpg
case_images: PMC11027594_01_10.1177_17588359241247023-fig3.jpg
case_images: fig3-17588359241247023
case_images: The results of the histological examination are shown in Figure 3.
case_images: PET CT scans.. (a and e) Diagnosis, August 2022. (a) Fluorodeoxyglucose (FDG) uptake is consistent with widespread metastasis in the skeletal system. (e) Lesion showing significant FDG uptake in segments 8 and 4 in the liver parenchyma. (b and f) Response to first treatment, November 2022. (b) Significant regression after 2 months of pazopanib. (f) In the liver parenchyma, the FDG uptake density of the malignant lesion area located in the previous study was regressed with an appearance infiltrating the right and left lobes and a mass lesion in this area with regression in size and minimal FDG uptake. (c and g) Progression, April 2023. (c) Progression of bone lesions. (g) A hypodense mass lesion located at the level of the 4-2 junction of the left lobe of the liver, morphologically similar to the previous study, but metabolically progressive, showing increased peripheral FDG uptake. (d and h) Response to combination therapy, July 2023. (d) Regression in bone lesions. (h) A peripheral hypodense lesion with slightly increased FDG uptake, located at the level of the hepatic left lobe segment 2-4 junction, similar in size to the previous study, but metabolically regressed.
case_images: 10.1177_17588359241247023-fig4.jpg
case_images: PMC11027594_01_10.1177_17588359241247023-fig4.jpg
case_images: fig4-17588359241247023
case_images: On a PET CT scan conducted after 2 months, an impressive reduction in tumor size was detected at all tumor sites with pazopanib monotherapy [Figure 4(b) and (f) Positron Emission Tomography Computed Tomography (PET CT) Scans - Response to First Treatment]. Upon attentively monitoring the patient's condition for 7.5 months, it has become evident that she was showing signs of disease progression [Figure 4(c) and (g) PET CT Scans-Progression). SUL (standardized uptake value corrected for lean body mass) peak value decreased by 53% compared to progression under pazopanib monotherapy and is consistent with a partial treatment response according to PERCIST (April SUL peak 2.86) post-treatment July 2023 SUL peak 1.33) [Figure 4(d) and (h) PET CT Scans-Response to Combination Therapy].
case_images: Patient's treatment timeline summarizing the course of action.
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case_images: PMC11027594_01_10.1177_17588359241247023-fig5.jpg
case_images: fig5-17588359241247023
case_images: The absence of any grade 3 or grade 4 side effects observed in the patient's response to this combinatory treatment instills optimism regarding its potential for further application and utilization in similar cases. The patient's journey from diagnosis until the last follow-up is summarized in the timeline presented in Figure 5.