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

Abstract

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. Electronic supplementary material The online version of this article (10.1186/s12885-019-5934-4) contains supplementary material, which is available to authorized users.

The Treatment for a Patient with Cancer of Unknown Primary: A Case Report

“…In a case of primary retroperitoneal serous adenocarcinoma, the combination of immunotherapy with radiotherapy decreased the tumor size, and subsequently led to durable disease control. 22 Another research study showed that radiotherapy may improve systemic responses to anti-PD1/PD-L1-directed immune therapy in Merkel cell carcinoma, and immunotherapy clearly showed abscopal regression. 23 Coincidentally, a case report also suggested that immunotherapy increases the chance of an abscopal effect occurring after radiation therapy in a patient with lung adenocarcinoma treated with atezolizumab and subsequently combined with brain irradiation for the treatment of metastasis.…”

Immunotherapy Combined With Chemotherapy and Radiotherapy for a Patient With Cancer of Unknown Primary: A Case Report

“…In a case of primary retroperitoneal serous adenocarcinoma, the combination of immunotherapy with radiotherapy decreased the tumor size, and subsequently led to durable disease control. 17 Another research study showed that radiotherapy may improve systemic responses to anti-PD1/PD-L1-directed immune therapy in Merkel cell carcinoma, as well as the immunotherapy has the clarity on abscopal regression. 18 Coincidentally, a case report also suggested that immunotherapy increases the chance of an abscopal effect occurring after radiation therapy in a patient with lung adenocarcinoma treated with atezolizumab and subsequently combined with brain irradiation for the treatment of metastasis.…”

Primary Retroperitoneal Carcinomas: New Insights into Pathogenesis and Clinical Management in Comparison with Ovarian Carcinomas and Carcinoma of Unknown Primary

“…Histological subtypes of retroperitoneal epithelial carcinomas include mucinous [ 8 , 9 , 10 , 11 , 12 , 13 ], serous [ 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 ], endometrioid [ 30 , 31 , 32 , 33 , 34 ], clear cell [ 35 , 36 , 37 , 38 ], and carcinosarcoma [ 39 , 40 , 41 ]. Morphologically, mucinous, serous, and endometrioid tumors resemble the phenotype of the colon, fallopian tube, and endometrium, respectively [ 42 ].…”