PMC9755706_01
CT scan of the pelvic cavity in August 2020. (a and b) Show the bladder carcinoma: a soft tissue mass (about 38 mm x 23 mm) with a wide base was seen in the bladder triangle, and the mass was uniformly enhanced in contrast CT. The bladder wall shown with limited thickening and stiffness. (c and d) Show the prostate carcinoma: The prostate was enlarged (about 52 mm x 43 mm) with uniform density. (a and c) belongs to the sagittal position. (b and d) belongs to the axial position.
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In August 2020, a 64-year-old male presented with haematuria and dysuresia for 2 weeks, both computerized tomography (CT) and ultrasound of the abdomen showed a tumour in the bladder triangle area (38 mm x 23 mm, Figure 1a and b) and another one in the prostate (Figure 1c and d).
The CT scan of the chest shows the lung carcinoma: (a) shows a nodular hyperdense shadow seen in the posterior segment of the left upper lobe of the lung with medium contrast in August 2020 (with a size about 11 mm x 12 mm). (b) Shows the lesion before chemotherapy plus immunotherapy against PD-1. (c) Shows that the lesion was significantly reduced after two cycles of chemotherapy plus immunotherapy against PD-1. (d) Shows that the lesion almost disappeared after radiotherapy.
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Chest CT found a nodule located in the left lung (11 mm x 12 mm, Figure 2a). As he refused surgery and radiotherapy for the lung lesion at that time, from March 20, 2021 to June 6, 2021, he received 4 cycles of pemetrexed and carboplatin plus pembrolizumab, the evaluation was partial response (PR) after second and fourth cycles (Figure 2b and c). After that, the lung lesion almost disappeared (Figure 2d) and he underwent regular follow up thereafter.
Histopathological section of the three carcinomas. (a) Shows P504S (+) in prostate adenocarcinoma. (b) Shows TTF-1 (+) in bladder urothelial carcinoma. (c and d) Show GATA-3 (+) and HE staining in NSCLC, respectively.
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The prostate puncture results on August 31, 2020 indicated prostate adenocarcinoma (Figure 3a), Gleason score was 3 + 4 = 7, immunohistochemistry was PSA (-), P504S (+), P63 (-), HCK (-), ki-67 (+, about 10%), Uroplakin II (UPK2) (-), and GATA-3 (-). The bladder cancer was partly resected on the same day, in order to release the obvious obstruction, and the pathology was bladder urothelial carcinoma (Figure 3b).