Volume 23, Number 4Case ReviewExceptional Response to Radiation Therapy to the Primary Tumor in a Patient With de Novo Metastatic Prostate Cancer With High Tumor Mutation BurdenBenjamin MercierAndrew TamDaniela V. CastroSalvador Jaime-CasasAbhishek TripathiYun Rose LiRegina Barragan-CarrilloWe present the case of a patient diagnosed with de novo, low-volume metastatic prostate cancer who received first-line treatment with androgen-deprivation therapy in combination with darolutamide. The patient presented with symptoms derived from local growth from the primary tumor and received pelvic radiation therapy to the primary tumor and pelvic nodes. He experienced complete tumor regression, with high serum prostate-specific antigen declining to nondetectable levels. Next-generation genomic analysis indicated high tumor mutation burden and high microsatellite status instability. Here, we contextualize this patient’s case regarding the importance of precision genomics in radiation oncology and its potential importance for optimizing treatment.Prostatic neoplasmsRadiation therapyNeoplasm metastasisAndrogen antagonistsprostate neoplasmcastration resistant
Volume 23, Number 3Kidney CancerResponse to Targeted Therapy and Checkpoint Inhibition in a Patient With Mucinous Tubular and Spindle Cell Carcinoma: A Case Report and Literature ReviewRuchi AgarwalDaniela V. CastroYu Jun LiJaya GoudSalvador Jaime-CasasMucinous tubular and spindle cell carcinoma (MTSCC) is a form of renal cell carcinoma characterized by its tubular structure, mucinous stroma, and spindle-shaped cells. It makes up less than 1% of all renal cell carcinoma cases and has been classically described as indolent, although the disease course varies. Here we analyze the case of a 67-year-old woman with metastatic MTSCC with a sarcomatoid component. The course of treatment was extensive and included targeted therapy and immunotherapy. Thus, this case review offers insight into the heterogeneous clinical course of MTSCC and potential therapeutic options for these patients.Immunotherapyimmune checkpoint inhibitorsCarcinoma, renal cellCarcinomaneoplasms, squamous, mucinous, and serouscarcinoma, tubular
Volume 23, Number 2Case of the QuarterCase of the Quarter: Kaposi Sarcoma in a Patient With Testicular Germ Cell Tumor and HIV: A Case Report and Literature ReviewDaniela V. CastroDonald HannounTanya B. DorffAlexander Chehrazi-RaffleWesley YipAbhishek TripathiBenjamin MercierRegina Barragan-CarrilloHedyeh EbrahimiSalvador Jaime-CasasTesticular germ cell tumors are the leading cause of cancer in male patients 15 to 39 years old. Extensive treatments are available, and the regimen of choice depends on clinical, laboratory, and histopathologic characteristics. Patients with HIV are at increased risk of developing solid malignancies, including testicular germ cell tumors. All patients with HIV should start on highly active antiretroviral therapy, but the drug interactions between chemotherapy for testicular germ cell tumor and highly active antiretroviral therapy have not been extensively evaluated. This case review highlights the importance of optimal therapeutic agent selection in patients with HIV and solid malignancies.Testicular neoplasmGerm cellHIVTesticular neoplasmsSarcoma