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Fig. 1 | World Journal of Surgical Oncology

Fig. 1

From: Multimodal treatment with curative intent in a germline BRCA2 mutant metastatic ampullary adenocarcinoma: a case report

Fig. 1

Schematic representation of patient’s clinical history. A Timeline summarizing main turning point of patient’s clinical history from initial diagnosis to last clinical and instrumental follow-up undergone in December 2022. B CA19.9 levels monitoring from diagnosis to last follow-up. C (I) Baseline CT scan performed in July 2019 and (II) assessment after 4 cycles of FOLFOX which demonstrated a major partial response in one of the liver lesions; (III) isolated retroperitoneal nodal relapse, nearby the superior mesenteric vessels, observed in October 2020 and (IV) the follow-up assessment at 36 months in which a complete response of nodal relapse was captured. The red arrows in the CT scans indicates the sites of neoplastic lesions (I, II, III) or their regression (IV). D Pedigree of the proband diagnosed with a germline BRCA2 W1692fs*3 mutation following its identification by somatic tumor next generation sequencing (NGS). The arrow indicates our patient (proband). Her sister, who tested negative for the same germline BRCA2 mutation, is indicated by a (-) symbol. Instead, her female cousin resulted positive and is here indicated by a ( +) symbol. The number represents the age of BRCA2 testing or cancer diagnosis, whichever comes first, and the organ represents the site of cancer origin (AC, ampullary cancer; OC, ovarian cancer; ALL, acute lymphoblastic leukemia). Roman numerals on the left edge represent generations. P, proband; squares, males; circles, females; oblique line, deceased; *, not tested; CR, complete response; PR, partial response; PD, progressive disease; NGS, Next Generation Sequencing; mOS, median overall survival

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