case_images: PMC11361990_01
case_images: PET-CT scan revealing increased metabolic activity within a nodular soft tissue density located in the posterior subcutaneous area of the upper arm.
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case_images: Figure 1 ). Following the doctor's advice, the patient underwent surgical resection of the upper arm soft tissue tumor on April 28th, 2018.
case_images: (A) HE and (A) Immunohistochemical staining.
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case_images: Actin (-), Melan-A (+), HMB45 (+), PAS staining (-) ( Figure 2 ). At this point, chest CT indicated no evidence of lung metastasis, while brain MRI and whole-body bone scan showed no significant abnormalities.
case_images: Post-completion of chemotherapy sessions, a follow-up chest CT scan revealed an augmented count and dimensions of nodules within bilateral lungs, indicating the emergence of lung metastases. (A) The lesion in the upper lobe of the right lung; (B) The lesion near the oblique fissure in the lower lobe of the right lung.
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case_images: After completion of all chemotherapy sessions, a repeat chest CT scan on April 3th,2019. showed an increase in the number and size of nodules in both lungs, suggesting the presence of lung metastases ( Figures 3A, B ).
case_images: Enhanced radioactive uptake and a peak standardized uptake value (SUVmax) of 5.8 are observed in a larger nodule (1.06cm x 1.4cm) situated near the oblique fissure of the right lower lobe. (A) The nodule is situated in the right upper lung near the pleura. (B) The nodule is situated near the oblique fissure of the right lower lobe.
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case_images: A larger nodule measuring approximately 1.06cm*1.4cm was located adjacent to the oblique fissure of the right lower lobe, exhibiting increased radioactive uptake with a maximum standardized uptake value (SUVmax) of 5.8 ( Figures 4A, B ).
case_images: Enhanced nodule dimensions within the lung, with the largest measuring approximately 2.0 cm. (A) The lesion in the upper lobe of the right lung; (B) The lesion near the oblique fissure in the lower lobe of the right lung.
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case_images: Anlotinib combined with chemotherapy still cannot halt the progression of the disease. ( Figures 5A, B ).
case_images: Significant reduction in lung nodule size observed after two cycles of chemotherapy incorporating a combination of 200mg sintilimab, 400mg albumin-bound paclitaxel, and 250mg apatinib as part of the treatment regimen. (A) The lesion in the upper lobe of the right lung; (B) The lesion near the oblique fissure in the lower lobe of the right lung.
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case_images: After assessing the patient's condition, we have adjusted the treatment plan to include a combination of 200mg Sintilimab, 400mg albumin-bound paclitaxel, and 250mg apatinib for 2 cycles of chemotherapy. After two weeks of treatment with the new treatment plan, we observed a significant reduction in the size of the nodules within the lungs compared to before ( Figures 6A, B ).
case_images: Longitudinal monitoring over a span of 3 years revealed consistent disease stability, as evidenced by regular chest CT scans. (A) The lesion in the upper lobe of the right lung; (B) The lesion near the oblique fissure in the lower lobe of the right lung.
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case_images: During the subsequent 3-year period, the patient underwent regular chest CT scans, and the disease remained stable ( Figures 7A, B ).