PMC9174540_01
At baseline (May 2019), contrast-enhanced CT (A) and MRI (B) indicated a 5.5-cm lesion in the liver with obvious enhancement on arterial phase images and washout on delayed images. After four cycles of chemotherapy (July 2019), contrast-enhanced MR (C) indicated stable disease (SD).
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The CT showed a 5.5x5.3 cm solid mass in the liver with a close relationship to the left portal vein and had no extrahepatic lesions (Figure 1A). Subsequent magnetic resonance imaging (MRI) revealed a 5.0 cm-sized well-defined solid mass with a cystic component, which was adjacent to the middle hepatic vein and left portal vein with peripheral biliary ductal dilatation and compression of the left branch of the portal vein (Figure 1B). MRI re-examination was performed after chemotherapy on October 9, 2019, revealing no change in the tumour size, which was evaluated as stable disease (SD) according to RECIST 1.1 (Figure 1C).
Pathological findings. (A) HE staining showed the tumour cells were arranged in nest and mass cord shape, and the cells were small and consistent. (B) AE1/AE3 staining showed diffuse cytoplasm was strongly positive. (C) Syno staining showed diffuse cytoplasmic positive. (D) ChrA staining showed diffuse cytoplasmic positive. (E) Ki-67 staining showed nuclear positive was about 5%. (F) CK18 staining showed diffuse cytoplasmic positive.
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AE1/AE3, CK18, Syno, and ChrA, with a Ki67 index of 5% (Figure 2). After treatment, the patient was regularly followed up, and each 3-monthly CT confirmed CR, exhibiting no signs of tumour progression (Figure 3).
The CT (A) and MRI (B) revealed reduction of tumour size after TACE and confirmation of complete response (CR) after surgery.
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AE1/AE3, CK18, Syno, and ChrA, with a Ki67 index of 5% (Figure 2). After treatment, the patient was regularly followed up, and each 3-monthly CT confirmed CR, exhibiting no signs of tumour progression (Figure 3).
Timeline of the patient's diagnosis and treatments.
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The timeline of the patient is summarised in Figure 4.