case_images: PMC7342556_01
case_images: Preoperative radiological examination of the patient. Liver MRI (A) +PWI (B) +DWI (C) showed that the hepatic portal and retroperitoneal lymph nodes were enlarged.. Abbreviations: MRI, magnetic resonance imaging; PWI, perfusion-weighted imaging; DWI, diffusion-weighted imaging.
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case_images: PMC7342556_01_OTT-13-6385-g0001.jpg
case_images: F0001
case_images: The liver magnetic resonance imaging (MRI)+ perfusion-weighted imaging (PWI)+ diffusion-weighted imaging (DWI) re-examination on September 28, 2018 showed that the hepatic portal and retroperitoneal lymph nodes were enlarged, and tumor metastasis was considered (Figure 1).
case_images: Postoperative pathological examination of the patient. (A) stain: hematoxylin and eosin (H&E), original magnificationx100; (B) stain: H&E, original magnificationx200.
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case_images: PMC7342556_01_OTT-13-6385-g0002.jpg
case_images: F0002
case_images: Postoperative pathology suggested moderately/poorly differentiated adenocarcinoma (CCA) (Figure 2) that invaded the nerves, with 1/1 lymph node metastasis in 13 groups.
case_images: Postoperative radiological examination of the patient. Liver MRI (A) +PWI (B) +PWI (C) showed long T2-weighted signals indicating limited hepatic portal diffusion and heterogeneous enhancement.. Abbreviations: MRI, magnetic resonance imaging; PWI, perfusion-weighted imaging.
case_images: OTT-13-6385-g0003.jpg
case_images: PMC7342556_01_OTT-13-6385-g0003.jpg
case_images: F0003
case_images: T2-weighted signals, limited hepatic portal diffusion and heterogeneous enhancement was observed (0.7x0.6 cm), indicating metastatic lesions (Figure 3).
case_images: Radiological examination after combination therapy in the patient. Liver MRI (A) +PWI (B) +PWI (C) showed that the long T2-weighted signals in the hepatic portal disappeared, and hepatic portal and retroperitoneal lymph node enlargement were not observed.. Abbreviations: MRI, magnetic resonance imaging; PWI, perfusion-weighted imaging.
case_images: OTT-13-6385-g0004.jpg
case_images: PMC7342556_01_OTT-13-6385-g0004.jpg
case_images: F0004
case_images: The long T2-weighted signals in the hepatic portal disappeared, and hepatic portal and retroperitoneal lymph node enlargement was not observed (Figure 4).