PMC7883677_01
Computed tomography images from the patient with esophageal squamous cell carcinoma. Computed tomography imaging revealed an expansile intraluminal esophageal mass and lung masses (A). The mass observed in brain computed tomography (B).
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The masses were visualized by chest and head CT ( Figure 1 ).
The mass on the chest wall was composed of poorly differentiated mucinous adenocarcinoma of the solid type. (A) Hematoxylin and eosin (H&E) staining, x40. (B) H&E staining, x200. (C) H&E staining, x400. (D) Her2 staining, x200. H&E, hematoxylin and eosin.
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Postoperative pathology showed that squamous cell carcinoma was moderately differentiated, with ulcer formation and invasion of striated muscle tissue ( Figures 2A-C ). The immunohistological staining result showed HER2 (3+) ( Figure 2D ).
The tumor markers after treatment with Herceptin combined with chemotherapy. CA125 (A), NSA (B), and CYFR-211 (C) decreased after treatment with Herceptin combined with chemotherapy.
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Laboratory tests results showed: carbohydrate antigen 125 (CA125), 239 micro/ml; neuron-specific enolase (NSE), 58.59 micro/ml; CYFR-211, 194.8 ng/ml ( Figure 3 ). Tumor biomarkers gradually decreased ( Figure 3 ).
The chest masses before and after treatment with Herceptin combined with chemotherapy. The masses rapidly decreased in size on aortopulmonary window images (A) and mediastinum window images (B) derived by chest computed tomography after treatment with Herceptin combined with chemotherapy.
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Chest CT re-examination on January 23, 2019 showed that the mass was significantly reduced in size ( Figure 4 ).
Brain masses observed by brain computed tomography before and after treatment.
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The metastatic mass was larger than before and new multiple lesions were found in brain CT ( Figure 5 ).
Timeline of events since diagnosis and summary of administered treatments.
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This patient's diagnosis and treatment are summarized in  Figure 6 .