case_images: PMC3975754_01
case_images: CT scan image showing a mass of 8 x 5 cm in the hilar area of the liver, involving the pancreas head and encasing regional blood vessels.
case_images: cro-0007-0155-g01.jpg
case_images: PMC3975754_01_cro-0007-0155-g01.jpg
case_images: F1
case_images: An abdominal computed tomography (CT) scan revealed a mass of about 8 x 5 cm in the hilar region of the liver, involving the head of the pancreas and encasing regional blood vessels (fig. 1).
case_images: PET-CT scan image showing partial response after 6 cycles of cisplatin-etoposide chemotherapy. The smaller size of the tumor (2 x 3 cm) and its epigastric and preaortic localization makes surgical treatment feasible.
case_images: cro-0007-0155-g02.jpg
case_images: PMC3975754_01_cro-0007-0155-g02.jpg
case_images: F2
case_images: Autogel (120 mg/4 weeks), injected deep subcutaneously, was initiated to control symptoms elicited by the secretion of hormones. After 6 cycles of chemotherapy, a partial response was observed: the size of the mass decreased to 2.3 cm, and was then interpreted as locally advanced, involving the epigastric and aortic area; no further lesions or PET activity were noticeable (fig. 2).
case_images: PET-CT scan image showing a complex pattern of multiple liver metastases.
case_images: cro-0007-0155-g03.jpg
case_images: PMC3975754_01_cro-0007-0155-g03.jpg
case_images: F3
case_images: AST, LDH, GGT) were 3-4 times over the upper limit of normal. A PET-CT scan showed that despite no local recurrence, the right liver lobe was extensively affected by a complex pattern of metastases (fig. 3), making surgical resection impossible.