PMC9807333_01
Case 1. Abdominal CT images before and after three courses of cisplatin and etoposide therapy. (a) Before treatment and (b) after the treatment courses.
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A computed tomography (CT) scan detected multiple liver, bone, and lymph node metastases with a high neuron-specific enolase (NSE) level of 171 ng/ml (Fig. 1a). After the third course, the metastatic sites shrunk significantly (Fig. 1b).
Case 1. The pathological results of the bone metastasis site biopsy. Immunohistochemistry was negative for PSA and positive for chromogranin A and synaptophysin. (a) Hematoxylin-eosin staining, (b) PSA, (c) chromogranin A, (d) synaptophysin.
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A biopsy of the bone metastases revealed the diagnosis of NEPC (Fig. 2), and the patient was referred to our hospital.
Case 1. CT images of the subclavian lymph node metastases before and 3 months after initiating olaparib. (a) Before treatment and (b) 3 months after olaparib treatment. Yellow arrow shows metastatic lymph node.
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After 3 months of treatment, the patient developed back pain and an enlarged left subclavian lymph node (Fig. 3a). Three months after, the back pain improved, and the lymph node metastasis had shrunk and was determined to be partial response (PR) (Fig. 3b).
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Case 2: CT images of the pelvic lymph nodes before olaparib treatment and 3 months after treatment. (a) Before treatment and (b) 3 months after olaparib treatment. Yellow arrow shows metastatic lymph node.
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Subsequently, the patient showed progression of pelvic lymph node metastasis (Fig. 4a). The results showed that the patient was positive for a somatic BRCA2 mutation. The lymph node shrank from 21.0 mm to 7.5 mm over the course of 3 months after olaparib administration (Fig. 4b).