UNASSIGNED: 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.
UNASSIGNED: Our individualized treatment strategy is successful. Pembrolizumab is safe and effective in the treatment of advanced vulvar verrucous carcinoma with PD-L1 overexpression.
■一名患者因过去14年的外阴损伤而入院。外阴肿块广泛侵入尿道,肛门的一部分,阴道的下三分之一,双侧耻骨上支和下支,双侧闭孔内外肌。盆腔中还发现了多个转移性淋巴结。组织病理学研究证实外阴疣状癌具有PD-L1过表达。经过六个疗程的新辅助化疗和pembrolizumab,患者接受了根治性外阴切除术,并实现了最佳的细胞减灭术。术后病理未见肿瘤残留。然后患者接受了一个疗程的术后化疗和pembrolizumab,接受了放射治疗,随访6个月后无病。
■我们的个体化治疗策略是成功的。派姆单抗治疗PD-L1过表达的晚期外阴疣状癌安全有效。