Primary clear-cell carcinoma of the liver with gastric antrum metastasis: Integrated management with targeted therapy, immunotherapy and salvage surgery: A case report.

This study reports the case of a patient diagnosed with primary clear-cell carcinoma of the liver (PCCCL). Intrahepatic metastasis transpired 1 month subsequent to the resection of the intrahepatic primary lesion. Subsequently, the patient commenced systemic treatment utilizing a combination of targeted drugs and programmed cell death-1 inhibitor. Immune-related adverse events (irAEs) manifested during the treatment process, encompassing persistent myelosuppression, hypothyroidism and a substantial elevation of adrenocorticotropic hormone levels. Rare gastric metastasis was identified during the follow-up course. Through multidisciplinary collaboration, entailing the sequential or combined implementation of surgery, targeted therapy and immunotherapy, along with the effective management of irAEs, the primary tumor, intrahepatic metastases and gastric metastasis in the patient were all effectively controlled. At the final follow-up, no signs of recurrence or metastasis were observed. This case underscores the highly invasive attributes of PCCCL, the diverse metastatic modalities (particularly the rare gastric metastasis), the actual efficacy of systemic treatment and the importance of complex irAE management, thus offering key guidelines for clinical practice.