BACKGROUND AND PURPOSE: Extrapulmonary small cell carcinoma (EPSCC) is a rare disease, which has a slightly better prognosis than small cell lung cancer, but still dismal. Gynecologic small cell malignancies tend to show a better survival than similar histologies of other regions. However, of five reported cases of vulvar manifestation only one patient was disease-free at the time of publication with limited follow-up. CASE REPORT: The authors describe a case of locally advanced small cell vulva carcinoma infiltrating the anal sphincter and urethra with spread to inguinal lymph nodes treated by radiochemotherapy and regional hyperthermia. After three cycles of carboplatin/ etoposide, computed tomography and magnetic resonance imaging indicated only little regressive transformations but overall stable disease. Surgical options were excluded. Therefore, curative radiotherapy to a total dose of > 65 Gy to macroscopic tumor, chemotherapy with cisplatin weekly, and regional hyperthermia were performed. Acute severe toxicity was limited to skin reactions. Despite the disadvantageous situation with inguinal lymph node metastases and chemoresistance, the multimodal therapy yielded a 5-year disease-free survival. CONCLUSION: Thus, the trimodal regimen of radiochemotherapy plus regional hyperthermia offered a curative chance in spite of resistance to the standard chemotherapy for irresectable, locally advanced small cell carcinoma of the vulva. Therefore, this approach merits further evaluation for limited disease of EPSCC.
BACKGROUND AND PURPOSE:Extrapulmonary small cell carcinoma (EPSCC) is a rare disease, which has a slightly better prognosis than small cell lung cancer, but still dismal. Gynecologic small cell malignancies tend to show a better survival than similar histologies of other regions. However, of five reported cases of vulvar manifestation only one patient was disease-free at the time of publication with limited follow-up. CASE REPORT: The authors describe a case of locally advanced small cell vulva carcinoma infiltrating the anal sphincter and urethra with spread to inguinal lymph nodes treated by radiochemotherapy and regional hyperthermia. After three cycles of carboplatin/ etoposide, computed tomography and magnetic resonance imaging indicated only little regressive transformations but overall stable disease. Surgical options were excluded. Therefore, curative radiotherapy to a total dose of > 65 Gy to macroscopic tumor, chemotherapy with cisplatin weekly, and regional hyperthermia were performed. Acute severe toxicity was limited to skin reactions. Despite the disadvantageous situation with inguinal lymph node metastases and chemoresistance, the multimodal therapy yielded a 5-year disease-free survival. CONCLUSION: Thus, the trimodal regimen of radiochemotherapy plus regional hyperthermia offered a curative chance in spite of resistance to the standard chemotherapy for irresectable, locally advanced small cell carcinoma of the vulva. Therefore, this approach merits further evaluation for limited disease of EPSCC.
Authors: Gregor Bruggmoser; Stefan Bauchowitz; Richard Canters; Hans Crezee; Michael Ehmann; Johanna Gellermann; Ulf Lamprecht; Nicoletta Lomax; Marc Benjamin Messmer; Oliver Ott; Sultan Abdel-Rahman; Rolf Sauer; Manfred Schmidt; Andreas Thomsen; Rüdiger Wessalowski; Gerard van Rhoon Journal: Strahlenther Onkol Date: 2011-09-19 Impact factor: 3.621
Authors: Anastasiya Atanasova Chokoeva; Georgi Tchernev; Elena Castelli; Elisabetta Orlando; Shyam B Verma; Markus Grebe; Uwe Wollina Journal: Wien Med Wochenschr Date: 2015-05-01
Authors: G Bruggmoser; S Bauchowitz; R Canters; H Crezee; M Ehmann; J Gellermann; U Lamprecht; N Lomax; M B Messmer; O Ott; S Abdel-Rahman; M Schmidt; R Sauer; A Thomsen; R Wessalowski; G van Rhoon Journal: Strahlenther Onkol Date: 2012-09 Impact factor: 3.621
Authors: Stephan M Huber; Lena Butz; Benjamin Stegen; Dominik Klumpp; Norbert Braun; Peter Ruth; Franziska Eckert Journal: Front Physiol Date: 2013-08-14 Impact factor: 4.566