PMC6881675_01
Immediate abdominal computed tomography revealing ascitic fluid in the peritoneal cavity, lymph node enlargement of hepatic portal (A, B) and a 19 x 13 mm2 metastatic lesion in the left medial segment of the liver (arrow) in August 2011.
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An immediate abdominal CT scan revealed hemoperitoneum, multiple round lesions within liver parenchyma and lymph node enlargement of hepatic portal (Fig. 1).
Histopathology of gastric cancer by biopsy showing undifferentiated carcinoma (hematoxylin and eosinstain; magnification, x400).
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Microscopic examination confirmed undifferentiated gastric carcinoma (Fig. 2).
Abdominal computed tomography revealed that the tumor with stable disease after two courses of FOLFOX chemotherapy via the portal vein in October 2011.
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Following the operation, the patient started 2 cycles of FOLFOX chemotherapy (oxaliplatin 85 mg/m2 IV on day 1, leucovorin 400 mg/m2 IV on day 1, fluorouracil 400 mg/m2 IV push on day 1, fluorouracil 1200 mg/m2 IV continuous infusion 46 h daily on day 1 and 2, cycled every 14 days) via the portal vein, and CT scan showed stable disease (SD) according to the response evaluation criteria in solid tumors (RECIST) 1.1 criteria (Fig. 3).
Clinical course and treatment of the patient. (1) Stable disease; (2) Computed tomography.
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Since the levels of the serum tumor marker (CEA, CA 724, CA 199) had small fluctuation (Fig. 5), the patient also received 8 courses of TACE, 2 courses of PEI, 1 course of RFA during this time.