Wang Yuhan, Lin Rongchun, Zhang Bingzhong, Zhou Hui, Lin Zhongqiu, Yao Tingting
Department of Gynecological Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, Sun Yat-sen University, Guangzhou, China.
Front Oncol. 2021 May 28;11:598594. doi: 10.3389/fonc.2021.598594. eCollection 2021.
Vulvar cancer is the fourth most common gynecologic cancer, and prognosis is poor in advanced vulvar cancer patients. Treatment for advanced vulvar cancer has not been satisfactory. In this report, we firstly report a FIGO IVB vulva verrucous carcinoma patient who obtained good prognosis after systemic treatment.
A patient was admitted to hospital due to her vulvar lesion persistent for past 14 years. The vulvar mass has widely invaded urethra, part of anus, the lower third of the vagina, bilateral superior and inferior branches of pubis, and bilateral internal and external muscles of obturator. Multiple metastatic lymph nodes were also found in the pelvic cavity. The histopathological studies confirmed vulvar verrucous carcinoma with a PD-L1 overexpression. After six courses of neoadjuvant chemotherapy and pembrolizumab, the patient underwent radical vulvectomy and achieved optimal cytoreduction. Postoperative pathology found no residual tumor. The patient then received one course of postoperative chemotherapy and pembrolizumab, underwent radiation therapy, and was disease free after 6 months follow-up.
Our individualized treatment strategy is successful. Pembrolizumab is safe and effective in the treatment of advanced vulvar verrucous carcinoma with PD-L1 overexpression.
外阴癌是第四常见的妇科癌症，晚期外阴癌患者的预后较差。晚期外阴癌的治疗效果一直不尽人意。在本报告中，我们首次报道了一名FIGO IVB期外阴疣状癌患者，经全身治疗后获得了良好的预后。
一名患者因外阴病变持续14年入院。外阴肿块广泛侵犯尿道、部分肛门、阴道下三分之一、双侧耻骨上下支以及双侧闭孔内、外肌。盆腔内还发现多个转移性淋巴结。组织病理学研究证实为外阴疣状癌，伴有PD-L1过表达。经过六个疗程的新辅助化疗和帕博利珠单抗治疗后，患者接受了根治性外阴切除术并实现了最佳肿瘤细胞减灭。术后病理未发现残留肿瘤。患者随后接受了一个疗程的术后化疗和帕博利珠单抗治疗，接受了放射治疗，随访6个月后无疾病复发。
我们的个体化治疗策略是成功的。帕博利珠单抗在治疗伴有PD-L1过表达的晚期外阴疣状癌方面安全有效。
