PMC9530699_01
Case presentation of patient 1. (A) Timeline of disease status. Tumor responses shown by ECT of pre- and post-neoadjuvant therapy and pathological diagnosis of the pancreas with fine needle aspiration. (B) H&E staining of the isolated pancreas and liver tissues after surgery.
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Biopsy revealed poorly differentiated pancreatic adenocarcinoma and no obvious cancer tissue in the liver ( Figure 1A ). Several small lymph nodes were found near the head of the pancreas and retroperitoneum, and the larger one was about 0.7 cm ( Figure 1A ). Tumor cells were found in the excised left liver lobe ( Figure 1B ).
PMC9530699_02
Case presentation of patient 2. (A) Timeline of disease status. Tumor responses shown by CT of pre- and post-neoadjuvant therapy and pathological diagnosis of pancreas and liver with fine needle aspiration. (B) CA-199 and CA-50 levels during treatment. 1st: receipt of the first PD-1 antibody and AG treatment. 2nd: receipt of the second treatment. 3rd: receipt of the third treatment. (C) H&E staining of the isolated pancreas and liver tissues after surgery.
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Finally, the patient was diagnosed with both pancreatic adenocarcinoma and metastatic liver adenocarcinoma upon biopsy ( Figure 2A ). Multiple round low-density shadows were seen in the liver, and the larger one was about 1.8x1.3 cm ( Figure 2A ). The levels of CA-199 and CA-50 were 64.2 IU/ml and 45.2 IU/ml, respectively ( Figure 2B ). Histopathological examinations revealed pancreas adenocarcinoma with liver metastasis (pT2N2M1), and no tumor cells were observed on the resection margins ( Figure 2C ).