PMC9423042_01
H&E and IHC of the patient's tumor. (A) H&E stain of tumor; (B) CK20 (-); (C) CDX2 (-); (D) MUC1 (+); (E), MUC2 (-); (F), MUC5AC (+).
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The tumor tissue was sent for pathological examination, which indicated moderately differentiated adenocarcinoma (Figure 1A). The sample was subtyped first by H&E staining and then by the evaluation of an IHC panel composed of CK20, CDX2, MUC1, MUC2, and MUC5AC (Figure 1). The IHC results are CK20 (-), CDX2 (-), MUC1 (-), MUC2 (-), and MUC5AC (-) (Figure 1B-F).
Changes of CT and serum markers during treatment. (A) CT image of the patient after 5-Fu-based chemotherapy before gemcitabine-based chemotherapy; (B) CT image of the patient After gemcitabine-based chemotherapy; A and B reflect the change of tumor size before and after treatment; (C) changes of CEA and CA125 during treatment.
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Re-examination on December 27, 2020, revealed multiple new liver metastases on enhanced CT of the upper abdomen (Figure 2A). After the patient regularly received three cycles of chemotherapy, CT enhancement on March 22, 2021, showed that the lesions had significantly decreased in size (Figure 2B). The CEA and CA125 levels continued to decline after changing the chemotherapy regimen (Figure 2C).