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Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report

BACKGROUND: Clear cell adenocarcinoma of the urethra is a rare type of aggressive cancer with a poor prognosis. Clear cell carcinoma of the urethra represents less than 0.02% of all malignancies in women. Adenocarcinomas account for 10% of female urethral carcinomas, of which 40% are the clear cell...

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Autores principales: Shields, Lisa B E, Kalebasty, Arash Rezazadeh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186237/
https://www.ncbi.nlm.nih.gov/pubmed/32355644
http://dx.doi.org/10.5306/wjco.v11.i4.243
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author Shields, Lisa B E
Kalebasty, Arash Rezazadeh
author_facet Shields, Lisa B E
Kalebasty, Arash Rezazadeh
author_sort Shields, Lisa B E
collection PubMed
description BACKGROUND: Clear cell adenocarcinoma of the urethra is a rare type of aggressive cancer with a poor prognosis. Clear cell carcinoma of the urethra represents less than 0.02% of all malignancies in women. Adenocarcinomas account for 10% of female urethral carcinomas, of which 40% are the clear cell variant. Determining the presence or absence of certain mutations through genetic testing may predict whether a patient with cancer may benefit from a particular chemotherapy regimen. CASE SUMMARY: A 40-year-old woman presented with a 3-year history of slow urinary flow and a 3-mo history of urinary urgency and frequency as well as gross hematuria. An abdominal and pelvic computed tomography scan demonstrated enlarged lymph nodes in the abdomen and pelvis. A biopsy of a left inguinal lymph node microscopically confirmed a metastatic adenocarcinoma of the urethra. Specialized genetic testing determined personalized chemotherapy. She was treated successfully with a non-platinum-based chemotherapy consisting of paclitaxel and bevacizumab. Following 3 cycles of paclitaxel and bevacizumab, she attained significant clinical improvement, and response by FDG-Positron emission tomography (PET) imaging showed a definite improvement in size and metabolic activity. She achieved complete response after 6 cycles of therapy by PET scan. The patient concluded 11 cycles of paclitaxel and bevacizumab, and a subsequent PET scan confirmed progression of metastatic disease. The patient was then treated with two cycles of doxorubicin after which a PET scan revealed a mixed response to the treatment. CONCLUSION: We report the first case of a patient with metastatic clear cell adenocarcinoma of the urethra who underwent personalized chemotherapy after testing for cancer gene alterations. Our unique case represents the safe and effective use of non-platinum-based chemotherapy in clear cell adenocarcinoma of the urethra.
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spelling pubmed-71862372020-04-30 Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report Shields, Lisa B E Kalebasty, Arash Rezazadeh World J Clin Oncol Case Report BACKGROUND: Clear cell adenocarcinoma of the urethra is a rare type of aggressive cancer with a poor prognosis. Clear cell carcinoma of the urethra represents less than 0.02% of all malignancies in women. Adenocarcinomas account for 10% of female urethral carcinomas, of which 40% are the clear cell variant. Determining the presence or absence of certain mutations through genetic testing may predict whether a patient with cancer may benefit from a particular chemotherapy regimen. CASE SUMMARY: A 40-year-old woman presented with a 3-year history of slow urinary flow and a 3-mo history of urinary urgency and frequency as well as gross hematuria. An abdominal and pelvic computed tomography scan demonstrated enlarged lymph nodes in the abdomen and pelvis. A biopsy of a left inguinal lymph node microscopically confirmed a metastatic adenocarcinoma of the urethra. Specialized genetic testing determined personalized chemotherapy. She was treated successfully with a non-platinum-based chemotherapy consisting of paclitaxel and bevacizumab. Following 3 cycles of paclitaxel and bevacizumab, she attained significant clinical improvement, and response by FDG-Positron emission tomography (PET) imaging showed a definite improvement in size and metabolic activity. She achieved complete response after 6 cycles of therapy by PET scan. The patient concluded 11 cycles of paclitaxel and bevacizumab, and a subsequent PET scan confirmed progression of metastatic disease. The patient was then treated with two cycles of doxorubicin after which a PET scan revealed a mixed response to the treatment. CONCLUSION: We report the first case of a patient with metastatic clear cell adenocarcinoma of the urethra who underwent personalized chemotherapy after testing for cancer gene alterations. Our unique case represents the safe and effective use of non-platinum-based chemotherapy in clear cell adenocarcinoma of the urethra. Baishideng Publishing Group Inc 2020-04-24 2020-04-24 /pmc/articles/PMC7186237/ /pubmed/32355644 http://dx.doi.org/10.5306/wjco.v11.i4.243 Text en ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Shields, Lisa B E
Kalebasty, Arash Rezazadeh
Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
title Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
title_full Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
title_fullStr Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
title_full_unstemmed Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
title_short Personalized chemotherapy in clear cell adenocarcinoma of the urethra: A case report
title_sort personalized chemotherapy in clear cell adenocarcinoma of the urethra: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7186237/
https://www.ncbi.nlm.nih.gov/pubmed/32355644
http://dx.doi.org/10.5306/wjco.v11.i4.243
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