PMC9891847_01
Preoperative colonoscopy and contrast-enhanced abdominal computed tomography (CT) findings/characteristic clinical findings. a Colonoscopy revealed a type 3 lesion of the transverse colon. Circumferential stenosis was noted. b CT showed circumferential wall thickening (yellow arrow) of the transverse colon. c, d Upper gastrointestinal endoscopy showed multiple areas of glycogenic acanthosis of the esophagus and several juvenile polyps in the stomach/duodenum. e, f Regarding dermal/mucosal lesions, papilloma-like protrusions of the oral mucosa/lingual apex (black arrow) and horny papules at the limb ends (white arrow) were observed. g CT and ultrasonography revealed a tumor measuring 8 x 8 mm in the right lobe of the thyroid gland (red arrow). Aspiration biopsy cytology demonstrated no malignant findings. h Upper gastrointestinal endoscopy 1 year after surgery showed a marked reduction in the glycogenic acanthosis of the esophagus.
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F1
The patient was a 39-year-old man with colitis obstructive due to circumferential transverse colon carcinoma (Fig. 1a, b, yellow arrows). Upper gastrointestinal endoscopy revealed multiple areas of glycogenic acanthosis of the esophagus and several juvenile polyps in the stomach/duodenum (Fig. 1c, d). Regarding dermal/mucosal lesions, papilloma-like protrusions of the oral mucosa/lingual apex, and horny papules at the limb ends were observed (Fig. 1e, black arrow and f, white arrow). Computed tomography (CT) and ultrasonography revealed a tumor measuring 8 x 8 mm in the right lobe of the thyroid gland (Fig. 1g, red arrow).
CT findings. a Peritoneal disseminated nodes (yellow arrow) were observed before the start of FOLFOXIRI + BEV therapy. b Their size decreased at the completion of the eighth course (red arrow). A partial response (PR) was achieved according to RECIST.
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F2
CT identified peritoneal disseminated nodes, leading to a diagnosis of recurrent peritoneal dissemination (Fig. 2a, yellow arrow). Tumors (RECIST) (Fig. 2b, red arrow). Transiently, there was no increase in the volume of cancerous ascites.
Clinical course of the patient. To treat peritoneal dissemination and cancerous peritonitis, FOLFOXIRI + bevacizumab (BEV) therapy was administered as the primary treatment, and FOLFIRI + panitumumab (PANI) therapy was administered as the secondary treatment. However, the patient died 18 months after surgery. CEA, carcinoembryonic antigen; CA19-9, carbohydrate antigen 19-9.
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F3
The patient died 18 months after surgery (Fig. 3).