Figure Legends
Figure 1. (a) Enhanced computed tomography performed before
surgical treatment. The black arrowhead indicates the liver tumor. (b) A
resected specimen. The black triangle indicates the liver tumor. (c) A
low-power-field view of the histological examination revealed components
of both hepatocellular carcinoma (HCC; white triangles) and
cholangiocarcinoma (white arrowheads). (d) A high-power-field view of
the HCC region. (e) A high-power-field view of the cholangiocarcinoma
region. (f) Immunohistochemical staining showed that the HCC regions
(white triangles) were positive and the cholangiocarcinoma regions
(arrowheads) negative for Hepa-para-1. (g) The cholangiocarcinoma
regions were positive for CK 19 (h) and CD 56. (i) The HCC regions were
negative for programmed death ligand-1 (PD-L1). (j) The
cholangiocarcinoma regions were negative for PD-L1.
Figure 2. Enhanced computed tomography showed multiple lymph
nodes metastases before Atez/Bev. (a) Lymph nodes around the abdominal
aorta. (b) A lymph node behind the inferior vena cava. (c, d) Left
supraclavicular lymph nodes
Figure 3. Enhanced
computed tomography after two cycles of therapy showed mild shrinkage of
enlarged lymph nodes, and the response rate per RECIST was determined to
be stable disease. (a) Lymph nodes around the abdominal aorta. (b) A
lymph node behind the inferior vena cava. (c, d) Left supraclavicular
lymph nodes.
Figure 4. Clinical course. The solid line indicates CA19-9, and
the dotted line indicates AFP. Black and white triangles indicate the
administration of atezolizumab and bevacizumab, respectively. AFP,
alfa-fetoprotein; CA 19-9, carbohydrate antigen 19-9; HR, hepatic
resection; GEM/CDDP, gemcitabine and cisplatin; LEN, lenvatinib.
Table 1. Laboratory findings