Journal Article

Exceptional response to chemotherapy followed by concurrent radiotherapy and immunotherapy in a male with primary retroperitoneal serous Adenocarcinoma: a case report and literature review

Sukhadia, Bhoomika, Chae, Young Kwang, Saleem, Naira, Viveiros, Pedro, Roh, Yoonhwan, Bilal, Haris, Lin, Xiaoqi, Sheikh, Muhammad Mubbashir, Park, Lee Chun

2019

Overview

Background Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely uncommon malignancy exclusively reported in females. Due to the rarity of the disease, it is difficult to establish a standardized treatment. Case presentation We describe a unique case of PRSA in a 71-year-old male who presented with right-sided lower back pain and numbness. Magnetic resonance imaging identified a mass invading the adjacent psoas muscle and twelfth rib. Tissue biopsy confirmed poorly differentiated PRSA. Patient was initially treated with neoadjuvant carboplatin and paclitaxel chemotherapy regimen. This resulted in complete radiological resolution of the tumor. However, 12 weeks later, rapid recurrence was noted on follow-up CT scan. The patient was then treated with external radiotherapy with concurrent nivolumab, an anti-PD-1 antibody. The patient displayed a positive response to treatment with reduction in primary tumor and metastases and had a sustained disease control. Conclusion Treatment with radiotherapy in combination with anti-PD-1 antibody could be an effective modality of management for PRSA.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Adenocarcinoma / Aged / Antibodies / Antineoplastic agents / Antineoplastic Agents, Immunological - pharmacology / Antineoplastic Agents, Immunological - therapeutic use / Antineoplastic Agents, Phytogenic - adverse effects / Antineoplastic Agents, Phytogenic - therapeutic use / Antineoplastic Combined Chemotherapy Protocols - adverse effects / Back pain / Biomedical and Life Sciences / Biomedicine / Cancer / Cancer metastasis / Cancer Research / Cancer treatment / Carboplatin / Carboplatin - adverse effects / Carboplatin - therapeutic use / Care and treatment / Case Report / CAT scans / Chemotherapy / Cystadenocarcinoma, Serous - diagnostic imaging / Cystadenocarcinoma, Serous - radiotherapy / Cystadenocarcinoma, Serous - therapy / Diagnostic imaging / Follow-Up Studies / Health Promotion and Disease Prevention / Humans / Immunologic Factors - therapeutic use / Immunotherapy / Immunotherapy - methods / Magnetic Resonance Imaging / Male / Medical and radiation oncology / Medicine/Public Health / Neoadjuvant Therapy / Neoplasm Recurrence, Local / Nivolumab / Nivolumab - pharmacology / Nivolumab - therapeutic use / Oncology / Paclitaxel - adverse effects / Paclitaxel - therapeutic use / Patient outcomes / Primary retroperitoneal serous adenocarcinoma / Programmed Cell Death 1 Receptor - antagonists & inhibitors / Programmed Cell Death 1 Receptor - immunology / PRSA / Radiotherapy / Retroperitoneal Neoplasms - diagnostic imaging / Retroperitoneal Neoplasms - radiotherapy / Retroperitoneal Neoplasms - therapy / Rivaroxaban / Surgical Oncology / Treatment Outcome / Tumors / Women