PMC9900132_01
PET-CT showed multiple masses located in the (A) left lower back, (B) right pelvic wall, and (C) inguinal region.
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September 2018, and it revealed a malignant tumor that was located on the left lower back with right pelvic wall and bilateral inguinal lymph node metastasis ( Figures 1A-C ). Surgery was performed to remove the lesion on the left lower back on 25 September 2018 with a tumor-free margin.
(A) Pathologic examination of tumor tissue confirmed typical SGC histological features (hematoxylin and eosin stain 100). (B) The tumor cells were positive for CK7 (CK7 stain 100). (C) The tumor cells were positive for P63 (P63 stain 100). (D) The tumor cells were positive for CK5/6 (CK5/6 stain 100). (E) The tumor cells were positive for partial CK14 (CK14 stain 100). (F) The expression of Ki-67 in tumor tissue (Ki-67 stain 100).
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Pathological inspections confirmed the diagnosis of SGC, and immunohistochemistry results indicated that the mass was CK7+, P63+, CK5/6+, CK14+partial, GCDFP-15-, GATA-3-, p40-, and Ki-67 10% ( Figures 2A-F ).
Pelvic MRI image of metastatic SGC (A) before docetaxel + nedaplatin treatment in October 2018; (B) after docetaxel + nedaplatin treatment in February 2019; (C) after the radiotherapy in September 2019; (D) before albumin-bound paclitaxel + camrelizumab treatment in December 2019; (E) after albumin-bound paclitaxel + camrelizumab treatment in September 2020; (F) before pemetrexed + nedaplatin + camrelizumab treatment in December 2020; and newly developed metastatic lymph nodes (G) before pemetrexed + nedaplatin + camrelizumab treatment in December 2020; (H) after pemetrexed + nedaplatin + camrelizumab treatment in March 2021. Arrows indicate the tumors in the groin region.
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Her magnetic resonance (MR) scanning image on 12 October 2018 showed that the number of lymph nodes increased in the bilateral inguinal region, and the left one was enlarged, suggestive of malignant disease ( Figure 3A ). MRI revealed stabilization of the disease ( Figure 3B ). After the radiotherapy, the patient was reviewed regularly, and the tumor size was obviously reduced ( Figure 3C ). However, MR scanning on 4 December 2019 revealed that the inguinal lymph nodes became larger ( Figure 3D ). During the treatment, MRI showed stabilization of the disease ( Figure 3E ). On 14 December 2020, MR scanning showed that the number and size of the inguinal lymph nodes increased and were larger than the previous ones ( Figures 3F, G ). However, the inguinal lymph nodes were poorly controlled and growing larger according to the MRI result ( Figure 3H ).
Summary of the treatment timeline of this case.
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The timeline for treatments and efficacy evaluations in this case is summarized in  Figure 4 .