Pembrolizumab as adjuvant therapy in a patient with Lynch syndrome with synchronous mixed clear cell carcinoma of ovarian origin and endometroid endometrial carcinoma

A 48-year-old woman was diagnosed with synchronous mixed clear cell carcinoma of ovarian origin and endometroid endometrial carcinoma after presenting with intermenstrual bleeding for 2 years prior. Shortly after diagnosis she became progressively unwell requiring intensive care unit admission with...

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Bibliographic Details
Published in:BMJ case reports 2021-11, Vol.14 (11), p.e245497
Main Authors: Batty, Kathleen, Li, Minmin, Baron-Hay, Sally
Format: Article
Language:English
Subjects:
Abdomen
Cancer therapies
Case Report
Case reports
Catheters
Chemotherapy
Colorectal cancer
Endometrial cancer
Family medical history
Genetic disorders
Gynecological cancer
Hospitals
Hypothyroidism
Hysterectomy
Immunotherapy
Medical imaging
Metastasis
Monoclonal antibodies
Oncology
Ovarian cancer
Patients
Pleural effusion
Respiratory failure
Targeted cancer therapy
Thoracic surgery
Tumors
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Summary:A 48-year-old woman was diagnosed with synchronous mixed clear cell carcinoma of ovarian origin and endometroid endometrial carcinoma after presenting with intermenstrual bleeding for 2 years prior. Shortly after diagnosis she became progressively unwell requiring intensive care unit admission with respiratory failure, pleural effusions and pulmonary emboli. Following a total abdominal hysterectomy, bilateral salpingo-oophorectomy, laparotomy and emergency percutaneous thrombectomy, she remained critically unwell and was deemed not safe for chemotherapy. Given a high index of suspicion for Lynch syndrome, the patient was treated with adjuvant pembrolizumab and achieved a complete response. Lynch syndrome was subsequently confirmed through germline genetic testing. The patient made an excellent recovery and remains disease-free at 23 months.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2021-245497