Case History
The patient is a 33 years old female presented with dysfunctional uterine bleeding and diagnosed a polyp outside.
Pelvic pain prompted further investigation indicating pelvic masses.
Biopsy was done outside which was suggestive of poorly differentiated carcinoma.
She came to Delhi for further evaluation and management.
Subtyping failed , therefore repeat biopsy was done.
And then she was diagnosed with endometrial cancer.
PET CT Scan was done , which showed mass lesion in relation to uterus and large necrotic pelvic nodes and para-aortic nodes with lung lesion.
In view of long wart between initial diagnosis and further subtyping of disease, 1 cycle chemo was given to forestall grave progression of disease beyond point of difficult return.
Post 1st cycle, there was drastic improvement in pain.
Again Biopsy was done, which confirmed Ca Endometrium High Grade WTI and PAX8 ER positive.
She was proposed chemotherapy but couldn’t afford it after few cycles.
Then she was proposed radiation but due to financial issues, she refused it.
Finally she agreed for Immunotherapy
Then she was put on Lenvatinib.
Because of unaffordable immunotherapy, the schedule was extended to once in 6 weeks.
Then it was further extended to once in 3 months.
Last schedule was given on -
Post 3 cycles, we recorded a very good response which was documented in the PET-CT scan.
There were subsequent PET-CT scan done, for which comparisons are documented below.
PET-CT scan post 1 cycle of chemotherapy and 3 cycles of immunotherapy.
PET-CT scan post 5 cycles of chemotherapy and 4 cycles of immunotherapy
PET-CT scan after last cycle of Immunotherapy