Durable complete remission with aromatase inhibitor therapy in a patient with metastatic uterine carcinosarcoma with poor performance status and coagulation disorders: a case reportReportar como inadecuado




Durable complete remission with aromatase inhibitor therapy in a patient with metastatic uterine carcinosarcoma with poor performance status and coagulation disorders: a case report - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Journal of Medical Case Reports

, 11:115

First Online: 19 April 2017Received: 29 September 2016Accepted: 06 March 2017DOI: 10.1186-s13256-017-1262-y

Cite this article as: Martin-Romano, P., Jurado, M., Idoate, M.A. et al. J Med Case Reports 2017 11: 115. doi:10.1186-s13256-017-1262-y

Abstract

BackgroundChemotherapy is considered the most appropriate treatment for metastatic uterine sarcoma, despite its limited efficacy. No other treatment has been conclusively proved to be a real alternative, but some reports suggest that anti-hormonal therapy could be active in a small subset of patients. We report the case of a patient with metastatic uterine carcinosarcoma with positive hormonal receptors and a complete pathological response.

Case presentationA 54-year-old white woman presented to our emergency room with hypovolemic shock and serious vaginal bleeding. After stabilization, she was diagnosed as having a locally advanced uterine carcinosarcoma with lymph nodes and bone metastatic disease. In order to control the bleeding, palliative radiotherapy was administered. Based on the fact that positive hormone receptors were found in the biopsy, non-steroidal aromatase inhibitor therapy with letrozole was started. In the following weeks, her general status improved and restaging imaging tests demonstrated a partial response of the primary tumor. Ten months after initiating aromatase inhibitor therapy, she underwent a radical hysterectomy and the pathological report showed a complete response. After completing 5 years of treatment, aromatase inhibitor therapy was stopped. She currently continues free of disease, without further therapy, and maintains a normal and active life.

ConclusionsThis case shows that patients with uterine carcinosarcoma and positive hormone receptors may benefit from aromatase inhibitor therapy. A multidisciplinary strategy that includes local therapies such as radiation and-or surgery should be considered the mainstay of treatment. Systemic therapies such as hormone inhibitors should be taken into consideration and deserve further clinical research in the era of precision medicine.

KeywordsUterine carcinosarcoma Hormonal receptors Aromatase inhibitors Complete pathological response Long-term survivor AbbreviationsAITAromatase inhibitor therapy

Ca-125Cancer antigen-125

CTComputed tomography

ECOGEastern Cooperative Oncology Group

PETPositron emission tomography

PSPerformance status

RTRadiotherapy

SUV maxMaximum standardized uptake value

UCSUterine carcinosarcoma





Autor: P. Martin-Romano - M. Jurado - M. A. Idoate - L. Arbea - J. L. Hernandez-Lizoain - D. Cano - J. A. Paramo - S. Martin-A

Fuente: https://link.springer.com/



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