PMC6458894_01
Coronal section of CT indicated the efficacy of neoadjuvant chemotherapy. Before chemotherapy (a). After 3 courses of CAPOX (b). After 5 courses, the tumor had disappeared (c).
CRIS2019-8129358.001.jpg
PMC6458894_01_CRIS2019-8129358.001.jpg
fig1
Contrast-enhanced computed tomography (CT) showed irregular colonic wall thickening with infiltration into the urinary bladder (Figure 1(a)). Follow-up CT after 3 courses of CAPOX revealed significant tumor shrinkage (Figure 1(b)). Follow-up CT after the treatment (5 courses of CAPOX and 1 course of capecitabine alone) showed tumor disappearance (Figure 1(c)).
Pathological findings revealed no viable cells with collagen fibers. Original magnification: x200.
CRIS2019-8129358.002.jpg
PMC6458894_01_CRIS2019-8129358.002.jpg
fig2
Well-tolerated pathological examination revealed no residual tumor cells in the resected specimen, which was consistent with pathological complete response (pCR) and grade 3 effect according to the Japanese Classification of Colorectal Carcinoma (Figure 2).
PMC6458894_02
Before treatment, CT scan revealed a bulky mass in the sigmoid colon invading the bladder (a). After 6 courses of CAPOX (b). CT failed to detect the tumor after 13 courses of CAPOX plus bevacizumab (c).
CRIS2019-8129358.003.jpg
PMC6458894_02_CRIS2019-8129358.003.jpg
fig3
Contrast-enhanced CT showed irregular colonic wall thickening with infiltration into the urinary bladder (Figure 3(a)). CT showed significant tumor shrinkage and reduction of bladder wall thickening (Figure 3(c)). Colonoscopy revealed the disappearance of the primary tumor.
Microscopic findings showed no residual tumor cells with foci of fibrotic tissue and inflammatory cell infiltration. Original magnification: x200.
CRIS2019-8129358.004.jpg
PMC6458894_02_CRIS2019-8129358.004.jpg
fig4
Pathological examination revealed no residual tumor cells in the resected specimen with foci of fibrotic tissue and inflammatory cell infiltration, which was consistent with pCR and grade 3 effect according to the Japanese Classification of Colorectal Carcinoma (Figure 4).
PMC6458894_03
Contrast-enhanced CT showed an irregular mass with infiltration into the bladder. The arrow indicates the communication between the mass and the bladder (a). After 5 courses of neoadjuvant chemotherapy, CT scan revealed shrinkage of the primary tumor (b).
CRIS2019-8129358.005.jpg
PMC6458894_03_CRIS2019-8129358.005.jpg
fig5
Contrast-enhanced CT showed irregular colonic wall thickening with massive involvement of the urinary bladder (Figure 5(a)). Follow-up CT after the neoadjuvant chemotherapy revealed significant tumor shrinkage (Figure 5(b)).
Viable cells were observed in less than one third of the lesion. The histological effect was consistent with grade 1a. Original magnification: x40.
CRIS2019-8129358.006.jpg
PMC6458894_03_CRIS2019-8129358.006.jpg
fig6
Pathological examination revealed that tumor cells or degeneration was present in less than one third of the entire lesion, which was consistent with grade 1a effect according to the Japanese Classification of Colorectal Carcinoma (Figure 6).