Response of cholangiocarcinoma with epigastric metastasis to lenvatinib plus sintilimab: A case report and review of literature

Figure 1 The first admission was hepatobiliary enhanced magnetic resonance imaging. A: Sagittal images shows carcinoma in the middle and lower segment of the common bile duct (orange arrow); B: Diffusion-weighted imaging images shows carcinoma size of 1.1 cm (orange circle); C: Retroperitoneal enlarged lymph nodes size of 1.5 cm (orange circle).

Figure 2 Baseline hepatobiliary enhanced magnetic resonance imaging before targeted immunotherapy. A: Right epigastric metastases size of 2 cm × 1.9 cm (orange circle); B: Liver metastases in S5 segment size of 1.3 cm × 1.2 cm (blue circle); C: Left lateral lobe of the livermetastasis size of 0.5 cm × 0.4 cm (blue circle); D: Carcinoma in the middle and lower segment of the common bile duct size of 1.1 cm (orange circle); E: Retroperitoneal enlarged lymph nodes size of 1.3 cm (orange circle).

Figure 3 Pathological report adenocarcinoma infiltrates hepatic encephalopathy (200 ×).

Figure 4 Hepatobiliary enhanced magnetic resonance imaging after two cycles of targeted immunotherapy. A: Right epigastric metastases size of 0.4 cm × 0.5 cm (orange circle); B: Liver metastases in S5 segment size of 1.8 cm × 1.7 cm (blue circle); C: Left lateral lobe of the livermetastasis size of 0.9 cm × 0.9 cm (blue circle); D: Carcinoma in the middle and lower segment of the common bile duct size of 1.1 cm (orange circle); E: Retroperitoneal enlarged lymph nodes size of 1.3 cm (orange circle).

Figure 5 Timeline of the case report. CT: Computed tomography.