Publication Name	World Journal of Clinical Cases
Manuscript ID	110330
Country	South Korea

Category	Surgery
Manuscript Type	Case Report
Article Title	Spontaneous colonic transection following pathologic complete response to pembrolizumab in high microsatellite instability colorectal cancer: A case report and review of literature
Manuscript Source	Unsolicited Manuscript
All Author List	Chungyeop Lee, Min Hyun Kim, Eu-Tteum Choi, In Ja Park, Seok-Byung Lim, Yong Sik Yoon, Chan Wook Kim, Jong Lyul Lee and Eun Jung Park
Funding Agency and Grant Number
Corresponding Author	Min Hyun Kim, MD, Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, 88, Olympic-ro 43-gil, Songpa-gu, Seoul 05505, South Korea. mhjerrykim@gmail.com
Key Words	Pembrolizumab; Colon cancer; High microsatellite instability; Mismatch repair deficient; Transection; Case report
Core Tip	We report here the first case of spontaneous colonic transection in a patient with high microsatellite instability colon cancer who achieved pathologic complete response after long-term pembrolizumab therapy. Despite no residual tumor on imaging or pathology, intraoperative findings revealed a discontinuity of the bowel at the original tumor site. Immune-mediated remodeling can compromise bowel integrity and may not be apparent on imaging. Clinicians should consider potential anatomic changes when planning surgery in patients treated with immunotherapy, even in the context of a complete response.
Citation	Lee C, Kim MH, Choi ET, Park IJ, Lim SB, Yoon YS, Kim CW, Lee JL, Park EJ. Spontaneous colonic transection following pathologic complete response to pembrolizumab in high microsatellite instability colorectal cancer: A case report and review of literature. World J Clin Cases 2025; In press

Received	2025-06-11 08:55
Peer-Review Started	2025-06-11 08:56
To Make the First Decision
Return for Revision	2025-06-22 10:43
Revised	2025-07-04 09:43
Second Decision	2025-08-12 02:56
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-08-13 10:10
Articles in Press	2025-08-13 10:10
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Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2307-8960 (online)
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