Evidence map›Paper›PMID 41113075›Full record

ArticleWorld journal of clinical cases2025

Spontaneous colonic transection following pathologic complete response to pembrolizumab in high microsatellite instability colorectal cancer: A case report and review of literature.

Chungyeop Lee, Min Hyun Kim, Eu-Tteum Choi, In Ja Park, Seok-Byung Lim, Yong Sik Yoon, Chan Wook Kim, Jong Lyul Lee, Eun Jung Park

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in World journal of clinical cases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Chungyeop LeeDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
Min Hyun KimDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea. mhjerrykim@gmail.com.
Eu-Tteum ChoiDepartment of Nursing, Asan Medical Center, Seoul 05505, South Korea.
In Ja ParkDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
Seok-Byung LimDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
Yong Sik YoonDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
Chan Wook KimDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
Jong Lyul LeeDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.
Eun Jung ParkDivision of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul 05505, South Korea.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh microsatellite instability (MSI-H) colorectal cancer (CRC), caused by deficient mismatch repair, accounts for about 15% of all CRC cases and is more common in right-sided tumors. While early-stage MSI-H CRC has a relatively good prognosis, advanced cases often respond poorly to standard chemotherapy. Immune checkpoint inhibitors, such as pembrolizumab, have shown strong and lasting effects in MSI-H CRC. Pembrolizumab is now approved as a first-line treatment for metastatic MSI-H CRC due to its superior outcomes compared to traditional chemotherapy. CASE SUMMARY: A 44-year-old male with MSI-H transverse colon cancer presented with hematochezia, abdominal pain, and significant weight loss. Imaging revealed a bulky tumor with invasion of adjacent structures and multiple liver lesions. A diverting ileostomy was performed followed by 36 cycles of pembrolizumab. The patient achieved a clinical and radiologic complete response. One month after completing the treatment, the patient underwent laparoscopic right hemicolectomy. A spontaneous transection of the colon at the original tumor site was unexpectedly identified. Final pathology confirmed pathological complete response (ypT0N0) with fibrosis. The patient recovered well after surgery, and follow-up showed no evidence of recurrence.

conclusionImmune checkpoint inhibitors may cause delayed structural damage to bowel tissue even after apparent complete tumor regression.

Indexed as

Case reportColon cancerHigh microsatellite instabilityMismatch repair deficientPembrolizumabTransection

Identifiers

PMID41113075
PMCPMC12531674

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