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Pembrolizumab as adjuvant therapy in a patient with Lynch syndrome with synchronous mixed clear cell carcinoma of ovarian origin and endometroid endometrial carcinoma
  1. Kathleen Batty1,
  2. Minmin Li2 and
  3. Sally Baron-Hay1
  1. 1Medical Oncology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  2. 2Familial Cancer Service, Royal North Shore Hospital, St Leonards, New South Wales, Australia
  1. Correspondence to Dr Kathleen Batty; kathleen.batty{at}health.nsw.gov.au

Abstract

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.

  • gynecological cancer
  • cancer - see oncology
  • genetic screening / counselling

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Footnotes

  • Contributors KB: Data collection, analysis and manuscript preparation. ML: Clinical genetics input, manuscript proof reading. SB-H: Patient diagnosis and treatment, manuscript writing guidance and proof reading.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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