PMC7573973_01
Changes in the condition after conversion therapy. (A) Positron emission tomography-computed tomography (PET-CT) showed increased FDG metabolism in the tail of the pancreas and the right lobe of the liver. (B) The histopathology of the pancreatic mass suggests adenocarcinoma. (C) PET-CT revealed a suppressed pancreatic tumor. (D) No malignant tumor cells were observed under the microscope. (E) The treatment process from the initial diagnosis to the end of follow-up. MR, magnetic resonance; M, metastasis; LN, lymph node; AS, albumin-bound paclitaxel plus S-1; GEM, gemcitabine; PD, progressive disease; PR, partial response; SD, stable disease.
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Positron emission tomography-computed tomography (PET-CT) revealed that low-density masses located in the tail of the pancreas and the right lobe of the liver, with unevenly increased FDG metabolism, several lymph node shadows were found in the abdominal aorta and the left common iliac artery of paravertebral (Figure 1A). The pathological result of laparoscopic biopsy suggested the adenocarcinoma (Figure 1B). CA19-9 dropped to the normal range. CT showed that the pancreatic tumor continued to shrink, and PET-CT revealed that the pancreatic tumor was suppressed (Figure 1C). No cancer cells were found in the primary lesion and dissected lymph nodes (Figure 1D). Until the end of the follow-up, the overall survival (OS) reached 31 months (Figure 1E).
PMC7573973_02
PMC7573973_03
PMC7573973_04
PMC7573973_05
Changes in the condition after conversion therapy. (A) Fluorodeoxyglucose (FDG) metabolism increased in the body of the pancreas and liver. (B) The histopathology of the liver mass suggests adenocarcinoma. (C) Positron emission tomography-computed tomography (PET-CT) showed that tumors were completely inactivated. (D) The treatment process from the initial diagnosis to the end of follow-up. M, metastasis; PR, partial response; CR, complete response; SD, stable disease; AG, albumin-bound paclitaxel plus gemcitabine.
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PET-CT showed that FDG metabolism was increased in the density focus of soft tissue in the body of the pancreas, multiple intrahepatic lesions, and some retroperitoneal lymph nodes (Figure 2A). The pathological biopsy of intrahepatic masses suggested poorly differentiated adenocarcinoma (Figure 2B). After four cycles, PET-CT showed that there was no significant increase in FDG metabolism in the pancreas and liver, so tumors were considered to be completely inactivated (Figure 2C). The OS at the end of this follow-up was 29 months (Figure 2D).