case_images: PMC4899638_01
case_images: a Endoscopic examination reveals type 2 advanced gastric cancer located in the antrum. b An initial abdominal CT reveals multiple metastatic lesions in the whole liver and ascites around the perihepatic space.
case_images: cro-0009-0106-g01.jpg
case_images: PMC4899638_01_cro-0009-0106-g01.jpg
case_images: F1
case_images: Upper gastrointestinal endoscopy revealed a type 2 advanced gastric cancer located in the antrum (fig. 1a). An abdominal computed tomography (CT) revealed multiple liver metastases, enlargement of both hepatic lobes, and a small amount of ascites in the perihepatic space (fig. 1b).
case_images: a CT after four treatment cycles revealed remarkable regression of the liver metastases and increased ascites. The scan also revealed decreased hepatic volume and a lobulation of the hepatic contour, which indicated pseudocirrhosis. Splenomegaly was not observed. b CT performed 5 months after initial treatment revealed further regression of the liver metastases and decreased ascites. c CT performed 8 months after initial treatment revealed that the ascites had disappeared. d CT performed 11 months after initial treatment revealed that the liver metastases had disappeared. e Endoscopic examination performed 9 months after initial treatment revealed that the primary tumor had been replaced by a red scar. No tumor cells were detected in a biopsy of the scar tissue.
case_images: cro-0009-0106-g02.jpg
case_images: PMC4899638_01_cro-0009-0106-g02.jpg
case_images: F2
case_images: After four cycles, CT revealed remarkable regression of the liver metastases with a nodular liver contour, liver volume loss, massive ascites, and pleural effusion (fig. 2a). CT revealed further regression of the liver metastases and decreased the as cites 5 months after initial treatment (fig. 2b); the ascites disappeared 8 months after initial treatment (fig. 2c). After 11 months of initial treatment, CT revealed complete remission of the liver metastases (fig. 2d). Upper gastrointestinal endoscopy revealed a red scar instead of the tumor, and no tumor cells were detected in the lesion by biopsy (fig. 2e), leading to the achievement of a complete response.