PMC8792461_01
Enhanced abdominal magnetic renounce imaging (MRI) of the reported case. (A) T2-weighted and arterial phase images of liver metastasis before camrelizumab combined with apatinib (November 6, 2020). The red arrows direct to the recurrent lesions in the liver. (B) MRI showed a partial response in liver metastasis from T2-weighted and arterial phase images after 2 cycles of combination therapy (December 22, 2020). The mass (arrow) adjacent to the surgical zone decreased to 0.6 cm in the maximum diameter (1.1 cm before treatment). The lesion under the liver capsule of S5 disappeared. (C) MRI showed that lesions in the liver completely disappeared after 4 cycles of combination therapy (February 1, 2021).
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In November 6, 2020, abdominal magnetic resonance imaging (MRI) indicated multiple lesions in the right lobe of the liver, the largest measuring 1.1 cm x 1.1 cm adjacent to the surgical zone ( Figure 1A ). Figure 1B ). Furthermore, lesions in the liver completely disappeared ( Figure 1C ) and CA-199 was reduced to normal levels (22.93 U/ml) after four cycles of treatment.
Histopathology of gallbladder carcinoma. (A) H&E stain, original magnification x100. (B) PD-L1 immunohistochemistry (antibody Ventana SP263), original magnification x200.
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TPS) and 20% (immune proportion score, IPS;  Figure 2 ). The profile of genetic alterations included ERBB2, AR, TERT, ERBB3, KMT2C, BTK, and TP53.
Timeline of the clinical course in this patient.
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The patient is still on treatment with camrelizumab (200 mg, Q3 weeks) plus apatinib (250 mg QD) as of the submission date of this article.  Figure 3  outlines the patient's history.