PMC10043298_01
PET/CT and coloscopy findings at baseline and after treatment. PET/CT showed disease status (A) before treatment and (B) after treatment. (C) The coloscopy showed the tumor in the right colon. (D) Immunohistochemistry of pre-treatment biopsy confirmed tumor cells. (E) Post-treatment coloscopy did not display any neoplasm. (F) Pathologic analysis of the tissue manifested chronic mucositis.
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Abdominal computed tomography (CT) revealed a neoplasm located in the right colon, and positron emission tomography/computed tomography (PET/CT) showed a thickened nodule in the retroperitoneal area ( Figure 1A ). Coloscopy was performed, and pathological analysis of the tumor revealed adenocarcinoma ( Figures 1C, D ). Post-treatment colonoscopy revealed no neoplasm, and immunohistochemistry revealed chronic mucositis ( Figures 1E, F ). PET/CT also showed that the patient achieved CR efficacy ( Figure 1B ).
Abdominal CT scanning of the patient. (A) A neoplasm located in the right colon and thickened nodule in the retroperitoneal were shown by CT before treatment. (B) After three cycles of the combination of mFOLFOX6 and bevacizumab, CT demonstrated shrunken tumors in abdomen. (C) The lesion of colon and nodular did not continue to regress after another two cycles of chemotherapy plus targeted therapy. (D) CT scan revealed that the lesions came to gradual diminishment after eight cycles of envafolimab. (E) Thirty-six cycles of envafolimab later, the lesion in the right colon completely disappeared. (F) The patient kept clinical complete response with the use of envafolimab 400mg every 3 weeks.
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A chest CT revealed interstitial pneumonia ( Figure 2 ), but the patient did not experience dyspnea.
Chest CT scanning of the patient. (A) CT showed lung status without disease before treatment initiation. (B) The patient developed interstitial pneumonia after three cycles of mFOLFOX6 and bevacizumab. (C) CT demonstrated lung injury did not progress after five cycles of chemotherapy and targeted therapy. (D) Interstitial lung disease still existed but did not worsen after two cycles of envafolimab. (E) The lung disorder even reversed after the patient challenged envafolimab 400mg every three weeks.
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Decreased CK and CK-MB were observed three days after management ( Figure 3 ).
Changes of CK and CK-MB throughout the process of the treatment.
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Thirty-six cycles later, the lesion in the right colon disappeared on an abdominal CT scan performed on 18 August 2022 ( Figure 4 ).