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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...
Autores principales: | , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2020
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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. |
format | Online Article Text |
id | pubmed-7186237 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
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 |
work_keys_str_mv | AT shieldslisabe personalizedchemotherapyinclearcelladenocarcinomaoftheurethraacasereport AT kalebastyarashrezazadeh personalizedchemotherapyinclearcelladenocarcinomaoftheurethraacasereport |