Gynecologic Oncology Reports最新文献

{"title":"Impact of carboplatin desensitization therapy on progression-free survival in gynecologic cancers","authors":"Nikita Bastin ,&nbsp;Halle Petrie ,&nbsp;Marc Robinson ,&nbsp;Amir Javid ,&nbsp;Robin Lane ,&nbsp;Taryn Boucher ,&nbsp;Alaina J. Brown ,&nbsp;Lauren S. Prescott ,&nbsp;Elizabeth Phillips ,&nbsp;Ronald D. Alvarez ,&nbsp;Marta Crispens ,&nbsp;Cosby A. Stone","doi":"10.1016/j.gore.2025.102017","DOIUrl":"10.1016/j.gore.2025.102017","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare survival between gynecologic cancer patients with carboplatin hypersensitivity thereafter managed with carboplatin desensitization, cisplatin replacement, and alternative non-platinum therapy.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who experienced a hypersensitivity reaction to carboplatin and were treated at the same comprehensive cancer center between 2010 and 2024 was completed. The primary analysis compared progression-free survival between carboplatin desensitization, cisplatin substitution, and alternative non-platinum therapy patients. Secondary analysis compared survival between platinum therapy and non-platinum alternative therapy patients. Descriptive analysis was further performed to delineate the clinical phenotypes of patients with carboplatin hypersensitivity.</div></div><div><h3>Results</h3><div>There were 47 gynecologic cancer patients with carboplatin hypersensitivity, and 38 patients with known progression-free survival. Progression-free survival was significantly longer in desensitized patients (31.1 months) vs. cisplatin patients (22.0 months, p = 0.045). There were no significant differences in progression-free survival between desensitized (31.3 months) and alternative therapy patients (36.0 months), as well as platinum (31.1 months) and non-platinum-based alternative therapy patients (36.0 months). A majority of our cohort was observed to have recurrent disease at the time of hypersensitivity (70.2 %), a carboplatin-free interval of 12 months or more (57.4 %), history of adverse reactions to other drugs (76.6 %), advanced stage disease (78.8 %), and serous histology (70.2 %).</div></div><div><h3>Conclusions</h3><div>Desensitized patients demonstrated increased progression-free survival as compared to cisplatin patients. This progression-free survival advantage may be due to the increased toxicity profiles noted for cisplatin and comparatively better tolerability of carboplatin desensitization. Progression-free survival was similar between carboplatin-desensitized and alternative therapy patients, as well as platinum-based and alternative therapy patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102017"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful use of immune checkpoint Inhibition in a patient with myasthenia gravis and recurrent endometrial cancer- expanding access beyond initial clinical trial eligibility","authors":"Olivia N. Julian ,&nbsp;Anika Christofsen ,&nbsp;Ramez N. Eskander","doi":"10.1016/j.gore.2026.102027","DOIUrl":"10.1016/j.gore.2026.102027","url":null,"abstract":"<div><h3>Background</h3><div> <!-->The use of immune checkpoint inhibitors<!--> <!-->(ICI)<!--> <!-->has transformed the treatment of patients with<!--> <!-->advanced stage or recurrent<!--> <!-->mismatch repair deficient (dMMR) endometrial cancer. Importantly, however,<!--> <!-->ICI<!--> <!-->are<!--> <!-->commonly contraindicated<!--> <!-->in patients with preexisting autoimmune conditions. Immune related myasthenia gravis (irMG) is the second most common neurologic<!--> <!-->immune related adverse event (irAE)<!--> <!-->with ICIs, and there have been several case reports of ICI induced myasthenia gravis (MG) as well as cases of MG flares associated with ICI treatment.</div></div><div><h3>Case Presentation</h3><div>This case report describes the successful use of pembrolizumab in combination with carboplatin and paclitaxel and then continued as maintenance in a 70-year-old patient with recurrent<!--> <!-->dMMR<!--> <!-->endometrial cancer and myasthenia gravis. Utilizing a multidisciplinary treatment team, the patient<!--> <!-->received<!--> <!-->plasmapheresis every 3 weeks, preceding pembrolizumab infusion, without clinical evidence of MG symptom flare. The patient<!--> <!-->remains<!--> <!-->in clinical<!--> <!-->remission<!--> <!-->8 months following completion of maintenance therapy.</div></div><div><h3>Conclusion</h3><div>Pembrolizumab was safely administered, without identifiable<!--> <!-->irAEs, and a robust clinical response in a patient with<!--> <!-->dMMR<!--> <!-->EC, where the clinical benefit of immunotherapy has been well established. Historically, patients with MG have been excluded from enrollment and treatment on clinical trials. Real<!--> <!-->world, pragmatic, clinical data may help inform expanded<!--> <!-->utilization<!--> <!-->beyond trial eligibility criteria.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102027"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146022729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary mandibular recurrence of uterine endometrial carcinoma successfully treated with chemotherapy alone: A case report","authors":"Takato Ishida,&nbsp;Shoji Maenohara,&nbsp;Hiroshi Yagi,&nbsp;Hideaki Yahata,&nbsp;Kiyoko Kato","doi":"10.1016/j.gore.2025.102013","DOIUrl":"10.1016/j.gore.2025.102013","url":null,"abstract":"<div><h3>Background</h3><div>Recurrence of endometrial carcinoma typically occurs in the pelvic region, with the lungs and lymph nodes being common sites for distant metastasis. However, recurrence involving the head and neck region is exceedingly rare.</div></div><div><h3>Case presentation</h3><div>We report a case of solitary mandibular recurrence of endometrial carcinoma successfully treated with lenvatinib and pembrolizumab. A 56-year-old woman was diagnosed with stage II clear cell carcinoma of the uterus. She underwent total abdominal hysterectomy, bilateral adnexectomy, partial omentectomy, appendectomy, pelvic and <em>para</em>-aortic lymphadenectomy. Postoperative adjuvant chemotherapy with six cycles of paclitaxel and carboplatin was administered, followed by observation. Two months after the completing of treatment, the patient developed trismus and pain in the left mandible. Imaging studies revealed a 4 cm mass in the left mandible. Needle biopsy confirmed a solitary recurrence of endometrial carcinoma. After the administration of pembrolizumab and lenvatinib therapy, the tumor was no longer detectable, which has been maintained.</div></div><div><h3>Conclusion</h3><div>Mandibular metastasis from endometrial carcinoma is extremely rare and may mimic primary jaw tumors. Treatment options include surgical resection, radiotherapy, and systemic therapy. A comprehensive evaluation of the primary tumor status, presence of other metastases, and the patient’s functional condition is essential for determining the optimal therapeutic strategy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102013"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145788036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Considerations on management of advanced cervical squamous cell carcinoma in a solid organ transplant and immunocompromised patient: A case report","authors":"Chista R. Irani ,&nbsp;Amelia Jernigan ,&nbsp;Amma Agyemang ,&nbsp;Tara Castellano","doi":"10.1016/j.gore.2026.102028","DOIUrl":"10.1016/j.gore.2026.102028","url":null,"abstract":"<div><h3>Introduction</h3><div>Immunocompromised patients, such as those with systemic lupus erythematosus (SLE) and solid organ transplantation (SOT) are at increased risk for persistent high-risk human papilloma viral (HPV) infection and cervical cancer due to chronic immunosuppression.</div></div><div><h3>Case</h3><div>A 35-year-old woman with SLE and a right pelvic renal transplant was diagnosed with HPV16-positive cervical squamous cell carcinoma. Despite history of abnormal Pap smear, inconsistent screening led to a delayed diagnosis. She underwent surgical management first followed by chemoradiation. Surgical pathology confirmed FIGO Stage IIIC1 disease. With disease progression to pulmonary, hepatic and osseous sites, the patient was started on platinum-based chemotherapy with immune checkpoint inhibitors leading to acute kidney transplant rejection. She was transitioned to dialysis and continues palliative chemotherapy.</div></div><div><h3>Conclusion</h3><div>This case highlights the challenges of treating cervical cancer in an immunosuppressed renal-transplant recipient and emphasizes the importance of individualized screening and multidisciplinary care. Immunotherapy use in transplant patients warrants cautious consideration with thorough risk–benefit counseling.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102028"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long lasting response to the combination of Avutometinib and Defactinib after progression on Binimetinib in a patient with recurrent low grade serous ovarian carcinoma − A case report","authors":"Victoria M. Ettorre ,&nbsp;Luca Palmieri ,&nbsp;Sarah Ottum ,&nbsp;Michelle Greenman ,&nbsp;Alessandro D. Santin","doi":"10.1016/j.gore.2025.102011","DOIUrl":"10.1016/j.gore.2025.102011","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of recurrent chemotherapy, aromatase (AI) and MEK Inhibitor (MEKi) resistant low grade serous ovarian cancer (LGSOC) remains a challenge. Novel treatment options for KRAS mutated MEKi resistant LGSOC are warranted.</div></div><div><h3>Case</h3><div>A 73-year-old with recurrent, metastatic, platinum-resistant LGSOC harboring a KRAS mutation experienced a prolonged response to the combination of Avutometinib and Defactinib after failing multiple lines of chemotherapy, aromatase inhibitor (AI), and targeted therapy with the MEK inhibitor Binimetinib (MEK-162). Following Avutometinib and Defactinib treatment, she experienced a confirmed and long-lasting (4 years) partial response as well as a return of CA-125 to baseline. The oral drug combination was well tolerated with no dose-limiting toxicity or need for dose reduction over the 4 year period.</div></div><div><h3>Conclusion</h3><div>The Avutometinib and Defactinib combination may represent a new standard treatment option for platinum-resistant and AI-resistant/recurrent LGSOC who have failed other MEKi.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102011"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145921636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences, obesity, and endometrial cancer: A case series and scoping review","authors":"Haley D. Frerichs ,&nbsp;Jenna B. Wowdzia ,&nbsp;Allison Sivak ,&nbsp;Sarah Chapelsky ,&nbsp;Christa Aubrey ,&nbsp;Sophia Pin","doi":"10.1016/j.gore.2026.102035","DOIUrl":"10.1016/j.gore.2026.102035","url":null,"abstract":"<div><div>Objective: To evaluate self-reported adverse childhood experiences (ACEs) in patients with endometrial cancer and class 3 obesity undergoing a preoperative weight loss protocol, and summarize the existing literature surrounding ACEs, endometrial cancer, and obesity.</div><div>Methods: We performed a retrospective chart review of 92 gynecologic oncology patients enrolled in a preoperative weight loss program from 2020 to 2022. Patients included in the case series had endometrioid carcinoma or atypical endometrial hyperplasia, class 3 obesity (body mass index ≥ 40 kg/m²), and at least one self-reported ACE. The scoping review followed PRISMA guidelines and included peer-reviewed studies evaluating ACEs in individuals with endometrial cancer or obesity.</div><div>Results: Seventeen of 92 patients (18.5%) with class 3 obesity and endometrial cancer self-disclosed a history of ACEs. The most frequent ACE types were psychological abuse (7/15, 15 46.7%), sexual abuse (6/15, 40%), and physical abuse (4/15, 26.7%). Patients had a mean of 6.4 ± 2.5 comorbidities, with 13/17 (76.5%) patients having at least one mental health disorder. The scoping review identified three studies that investigated ACEs in endometrial cancer patients and found that ACEs may negatively impact gynecologic care. Various ACE types are linked to obesity, with a stronger association between ACEs and obesity in women versus men.</div><div>Conclusion: Patients with endometrial cancer, class 3 obesity, and ACEs in our study reported a high degree of abuse and medical comorbidities. ACEs appear to increase the risk of endometrial cancer via obesity and complicate patient care, but a formal association cannot be established.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102035"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170165","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"#DidYouKnow: Physician engagement online and offline is mission critical to promote accurate and impactful cervical cancer information dissemination","authors":"Sarah S. Lee ,&nbsp;Teresa K.L. Boitano ,&nbsp;Megan L. Hutchcraft ,&nbsp;Susan C. Modesitt","doi":"10.1016/j.gore.2026.102042","DOIUrl":"10.1016/j.gore.2026.102042","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102042"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 pandemic and healthcare utilization in ovarian cancer patients","authors":"Amrita Mukherjee ,&nbsp;Natalie Ayoub ,&nbsp;Lanfang Xu ,&nbsp;Kimberly L. Cannavale ,&nbsp;Elizabeth A. Szamreta ,&nbsp;Matthew J. Monberg ,&nbsp;Melissa Hodeib ,&nbsp;Chun R. Chao","doi":"10.1016/j.gore.2025.102019","DOIUrl":"10.1016/j.gore.2025.102019","url":null,"abstract":"<div><h3>Objectives</h3><div>We evaluated the impact of the COVID-19 pandemic on healthcare utilization and short-term safety outcomes in ovarian cancer patients.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Methods</h3><div>Epithelial ovarian cancer patients (n = 799) diagnosed between 01/01/2017–06/30/2021 at Kaiser Permanente Southern California were included. Pre-pandemic and pandemic periods were defined using 03/04/2020 (implementation of stay-at-home order in California) as the cut-off. Care utilization outcomes included the number of office and virtual visits per person-month, number of CA125, complete blood count, electrolytes, and creatinine tests done for chemotherapy monitoring. Short-term safety outcomes included the number of emergency room (ER) visits and hospitalizations per person-month. Negative binomial models were used to evaluate associations.</div></div><div><h3>Results</h3><div>Overall, 72.7 % and 27.3 % of the patients were diagnosed during the pre-pandemic and pandemic period, respectively. Mean (S.D.) number of office visits per person-month decreased during the pandemic period [0.4 (0.5) vs 0.6 (0.6) in pre-pandemic, p-value &lt; 0.01]. Mean number of virtual visits increased during the pandemic [0.4 (0.7) vs 0.2 (0.3) in pre-pandemic, p-value &lt; 0.01]. The number of virtual visits was twice during the pandemic vs the pre-pandemic period [adjusted-rate ratio (95 %CI): 2.04 (1.54–2.72)]. No differences in ER visits were observed by pandemic periods. Hospitalization rate was lower during the pandemic [adjusted-RR (95 %CI): 0.85 (0.72–1.00)]. In patients who received chemotherapy (n = 684), no differences in chemotherapy monitoring were observed.</div></div><div><h3>Conclusions</h3><div>Despite a shift from office visits to virtual visits during COVID-19, no differences in laboratory monitoring of chemotherapy and no increase in ER visits and hospitalizations were observed in ovarian cancer patients.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102019"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypofractionated short course radiation therapy for recurrent ovarian cancer","authors":"Emily A. Miller ,&nbsp;Amita Kulkarni ,&nbsp;Jeff F. Lin ,&nbsp;Evelyn Cantillo ,&nbsp;Melissa K. Frey ,&nbsp;Eloise Chapman-Davis ,&nbsp;Higinia Cardenes ,&nbsp;Kevin Holcomb","doi":"10.1016/j.gore.2026.102021","DOIUrl":"10.1016/j.gore.2026.102021","url":null,"abstract":"<div><div>Background: While chemotherapy has largely replaced radiation therapy in upfront treatment of ovarian cancer, radiation has shown potential in the recurrent setting where chemoresistance, toxicities, and patient preferences may limit other treatment options. Hypofractionated radiation therapy (HFRT) is a highly conformal radiation therapy in which higher doses of radiation are delivered per treatment with the goal of fewer treatments. Objectives: To evaluate treatment response and survival for patients with recurrent ovarian cancer treated with HFRT and to evaluate treatment toxicity.</div><div>Methods: This was a retrospective cohort study of patients who received HFRT for the treatment of recurrent ovarian cancer at a single, large academic institution. Patient demographics, tumor characteristics, and treatment history details of the HFRT were collected via electronic medical record chart review. Outcomes including treatment response, survival and toxicity profile were analyzed. Treatment response was defined by RECIST 1.1 criteria. Toxicities were defined using the Radiation Therapy Oncology Group Criteria.</div><div>Results: 22 patients were reviewed. 1 patient (4.55%) had a complete response, 8 patients (36%) had a partial response, 7 patients (32%) had stable disease and 3 patients (14%) had progressive disease, and 3 patients (14%) were unevaluable by RECIST 1.1 criteria after treatment with HFRT. Mean progression free survival (PFS) was 11.5 months and overall survival (OS) was 28.7 months. HFRT was well-tolerated with no Grade 3 or 4 toxicities. The majority of patient’s had one to two lesions which were targeted for treatment.</div><div>Conclusions: For well-selected patients, particularly those with oligometastatic disease, HFRT should be considered as an additional treatment option for recurrent ovarian cancer.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102021"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145972989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metastatic high-grade undifferentiated ovarian carcinoma: A case report from Sub-Saharan Africa","authors":"John Lugata ,&nbsp;Caleigh Smith ,&nbsp;Fortunata Nzota ,&nbsp;Abitalis Mayengela ,&nbsp;Tecla Lyamuya ,&nbsp;Albert Masenga ,&nbsp;Eusebious Maro ,&nbsp;Bariki Mchome ,&nbsp;Alex Mremi","doi":"10.1016/j.gore.2026.102041","DOIUrl":"10.1016/j.gore.2026.102041","url":null,"abstract":"<div><h3>Background</h3><div>Undifferentiated ovarian carcinoma (UDOC) is an exceptionally rare and highly aggressive subtype of epithelial ovarian cancer, accounting for less than 1% of cases and infrequently reported in the literature, particularly in resource-limited settings. To our knowledge, this represents the first reported case of metastatic UDOC from Sub-Saharan Africa.</div></div><div><h3>Case presentation</h3><div>We report a case of high-grade UDOC in a 63-year-old postmenopausal woman presenting to a tertiary referral center in Northern Tanzania with a one-year history of progressive abdominal pain, distension, early satiety, and weight loss. Imaging demonstrated a large heterogeneous pelvic mass with extensive exophytic hepatic metastases and omental involvement, consistent with advanced-stage disease. Exploratory laparotomy revealed a frozen pelvis with extensive adhesions and intraabdominal metastases, precluding optimal cytoreductive surgery. Histopathologic evaluation demonstrated sheets of poorly differentiated tumor cells with marked cytologic atypia and high mitotic activity, a high proliferative index, and negative staining for Wilms tumor 1 (WT1), estrogen receptor (ER), and epithelial membrane antigen (EMA), supporting the diagnosis of FIGO stage IVB UDOC. Multidisciplinary tumor board review recommended platinum-based chemotherapy; however, treatment was not initiated due to financial barriers, and the patient was subsequently lost to follow-up.</div></div><div><h3>Conclusion</h3><div>UDOC is a rare and aggressive malignancy that often presents at an advanced stage with nonspecific gastrointestinal symptoms and widespread metastases. This case highlights the intersection of aggressive tumor biology and structural healthcare barriers that continue to limit access to timely cancer diagnosis and treatment in resource-constrained settings, underscoring persistent disparities in global cancer care delivery.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"63 ","pages":"Article 102041"},"PeriodicalIF":1.3,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146170247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}