PMC9971949_01
Total body computed tomography scan showing the metastatic melanoma in the liver (red arrows).
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A total body computed tomography (CT) scan (Figure 1) revealed hepatomegaly (25*19 cm in diameter), several nodules in both lungs suspected of being metastasis (the biggest was 15 mm in diameter), enlargement of the lymph nodes in the hilum of both lungs, a space occupying lesion (SOL) in the vertebral area (D10), a SOL in the fundus of the stomach (6 cm in diameter), multiple SOLs in the liver (the biggest was 5 cm in diameter), enlargement of the lymph nodes in the hilum of the liver (the biggest 5 cm in diameter, SOLs in the head of the pancreas, SOLs in the bilateral adrenals, and several enlarged lymph nodes in the abdominal space.
Pictures that were taken during gastroscopy which showing the active bleeding.
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The patient was sent for an urgent gastroscopy, which showed four peptic ulcers in the stomach (2 ulcers in the antrum, 1 ulcer in the body and 1 ulcer in the fundus) (Figure 2).
The patient's timeline for cancer treatment and bilirubin levels.
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After two weeks (al-most a month after starting treatment), bilirubin levels were within the normal range (0.54 gm/dL) (Figure 3).
Positron emission tomography- computed tomography showing the significant response with disappearing of most liver metastasis.
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One month later a positron emission tomography PET- CT scan (Figure 4), showed a significant improvement with the disappearance of the lung nodules, lymph nodes in the hilum of both lungs being of normal size, the disappearance of the SOL in the D10 area, decreased diameters of the SOLs in the head of the pancreas, a decreased diameter of the SOL in the fundus of the stomach (to 2.8cm), the disappearance of some of the SOLs in the liver, and decreased diameters of the lymph nodes in the liver hilum.