PMC7807117_01
History of gastric cancer treatment. The trend in tumor markers (CEA and CA19-9) was a good reflection of disease progression. Nivolumab was well tolerated with no serious adverse events for about 1 year. CA19-9: carbohydrate antigen 19-9, CEA: carcinoembryonic antigen
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Overall, nivolumab was continued for approximately 1 year (28 cycles), but the primary tumor gradually again became enlarged (Fig. 1).
T1-weighted axial (A) and sagittal (B) contrast-enhanced magnetic resonance image (MRI). A clival mass involving the right jugular process and the right hypoglossal canal was discovered on brain contrast-enhanced MRI (white arrow).
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We found heterogeneity in a clival mass with diffuse enhancement after gadolinium administration (Fig. 2).
Plain computed tomography. Neither plain CT nor MRI showed stroke, cerebral hemorrhage, or brain metastasis. Upon subsequent review, the irregular bone cortex near the right hypoglossal canal was found on plain CT.
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Upon subsequent review, the irregular bone cortex near the right hypoglossal canal was found on the plain CT (Fig. 3).
Radiation therapy. We performed palliative radiotherapy (30 Gy/10 fr). His headache and tongue deviation gradually improved. The adverse event of transient dysgeusia occurred. At the time of writing, his neurologic disorder had clearly improved and his symptoms had not recurred.
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He received palliative radiotherapy (30 Gy/10 fr) (Fig. 4); subsequently, his headache and tongue deviation gradually improved, but he experienced transient dysgeusia.