PMC6599432_01
Thoracic-abdominal enhanced computed tomography (ECT).. A, B. ECT showing the wall thickness of the ascending colon, ascites in the pelvic cavity and right upper abdomen, and suspected peritoneal disseminations (PDs) (arrow) in the left upper abdomen. C, D. After 18 courses of chemotherapy, the volume of the ascending colon cancer had shrunk to around 50% and peritoneal disseminations and ascites had disappeared.
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Thoracic and abdominal enhanced computed tomography (ECT) showed the wall thickness of the ascending colon, ascites in the pelvic cavity and right upper abdomen, and suspected peritoneal disseminations (PDs) in the left upper abdomen (Fig. 1a, b). After 18 courses of this chemotherapy, abdominal ECT showed that the tumor volume had shrunk to around 50% and PDs and ascites had disappeared (Fig. 1c, d).
Intraoperative findings.. A, B. Extensive PDs in the peritoneal cavity including the greater omentum. C, D. After 18 courses of Pmab plus mFOLFOX6, the PD sites appeared as white scarring and ascites cytology was negative for adenocarcinoma.
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Intraoperatively, we observed extensive PDs in the peritoneal cavity including the greater omentum (Fig. 2a, b). Intraoperatively, the PDs were visible as white scarring and ascites cytology was negative for adenocarcinoma (Fig. 2c, d).
Histopathological findings.. A, B. Hematoxylin and eosin (HE) staining of ascending colon cancer showing extensive fibrosis from the submucosa to the subserosal tissue with ductal adenocarcinoma duct (arrow) in the muscularis propria. C, D. HE staining of the omentum revealing almost burned-out lesions with ductal adenocarcinoma (arrowhead).
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HE staining of the omentum revealed almost burned-out lesions with some duct adenocarcinoma (Fig. 3a-d).
ECT.. A, B. New PDs detected by follow-up abdominal ECT 7 months after surgery. C, D. The target lesion had completely disappeared after nine courses of Pmab plus mFOLFOX6 for new PDs.
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Although we had undertaken clinical follow-up after the operation without through patient choice and because there were no target lesions, new PDs were detected by follow-up abdominal ECT (Fig. 4a, b) 7 months after surgery. After nine courses of this therapy, the target lesion had completely disappeared on ECT (Fig. 4c, d), so we evaluated this therapy as a complete response (CR).