CURiE Conversations: Definitive Radiotherapy in Serous Carcinoma of Unknown Primary With Isolated Nodal Disease: A Case Review

Thank you.

So could you briefly, um, tell us a little bit about the case? For some background for our, um, listeners here, high-grade serous carcinoma most commonly arises from the ovary, fallopian tube, endometrium, or the peritoneum.

In rare cases, however, no primary site can be identified.

And in your report you tell us about an 88-year-old female that presented with an isolated pelvic and inguinal nodal disease from a mullerian high-grade serous carcinoma without a detectable primary tumor.

And following progression on endocrine therapy, she underwent definitive, um, radiation and achieved durable disease, um, for more than 30 months.

So could you tell us what motivated you to publish this case, and what are some of the key findings that you were able to find from your research?

Yeah.

So what really motivated us to publish this case was the combination of the fact that the rarity of the presentation, the treatment approach, and the durability of the response of the radiotherapy that we had did.

So high-grade ca- high-grade serous carcinoma typically presents with adnexal, uterine, peritoneal, or disseminated disease.

And this patient, it was isolated to the inguinal and pelvic lymph nodes with no identifiable, uh, primary, which is very uncommon.

So the other striking part that motivate- motivated us to publish this case was the fact that this was an elderly, elderly lady with a significant cardiac comorbidity, so the standard approaches like surgery or chemotherapy were not ideal.

So despite that, our treatment approach, the definitive th- radiotherapy, led to no- normalization of her CA125 levels, and also durable disease control for more than 30 months.

So this case highlights a rare disease biology, but also potential meaningful treatment option for medically frail patients who don't, um, who don't, who don't, um, can't get surgery.

Yeah.

And the few case reports that do exist for this really do just focus on chemo and surgery.

So this was the first, I think, that really focused on radiation.

Great.

Thanks for sharing that.