Gynecologic Oncology Reports最新文献

{"title":"Impact of preserving circumflex iliac nodes distal to the external iliac nodes (CINDEIN) on prognosis in low-risk endometrial cancer patients","authors":"Yasushi Yamada,&nbsp;Hisanori Kobara,&nbsp;Masako Nakajima,&nbsp;Hirofumi Ando,&nbsp;Tsutomu Miyamoto","doi":"10.1016/j.gore.2026.102181","DOIUrl":"10.1016/j.gore.2026.102181","url":null,"abstract":"<div><h3>Aim</h3><div>Sentinel lymph node (SLN) mapping has become the standard approach for lymph node (LN) assessment in patients with low-risk endometrial cancer (EC). However, until its coverage by the Japanese national health insurance system in 2025, pelvic lymphadenectomy (PLA) had been routinely performed for nodal assessment in Japan. The resection of circumflex iliac nodes distal to the external iliac nodes (CINDEIN) in PLA is associated with an increased risk of lymphedema. CINDEIN preservation in EC patients reduces the risk of lymphedema; however, the impact of CINDEIN preservation on recurrence patterns and prognosis is unclear. Therefore, we herein examined the effects of CINDEIN preservation on recurrence patterns, survival outcomes, and lymphedema in patients with low-risk EC.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 65 patients with preoperatively diagnosed low-risk EC who underwent PLA as their initial treatment between January 2016 and December 2024. Patients were divided into two groups according to whether CINDEIN was resected or preserved, and treatment effects and prognosis were evaluated.</div><div>Results: Lymphedema was noted in 1 case in the CINDEIN-preserved group (2.7%) and in 7 in the CINDEIN-resected group (25%), demonstrating a significant difference (<em>P</em> = 0.017). Recurrence was noted in 4 cases in the CINDEIN-preserved group and in 2 in the CINDEIN-resected group (<em>P</em> &gt; 0.05). There were no significant differences in PFS or OS between the two groups.</div></div><div><h3>Conclusions</h3><div>CINDEIN preservation may be performed on patients with low-risk EC without worsening their prognosis and correlated with a reduced risk of lymphedema.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102181"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concordance of folate receptor expression in ovarian cancer over time: A single-institution retrospective study","authors":"Mitra Abdollahi Neisani,&nbsp;Francis E. Marrero,&nbsp;Roberto Angeli-Morales,&nbsp;Sinan G. Khudhur,&nbsp;Kevin J. Wu,&nbsp;Yaohua Ma,&nbsp;Sophia G. Blumenfeld,&nbsp;Karina Hanna,&nbsp;Gerardo Colon-Otero,&nbsp;Aziza Nassar","doi":"10.1016/j.gore.2026.102179","DOIUrl":"10.1016/j.gore.2026.102179","url":null,"abstract":"<div><h3>Background</h3><div>Folate receptor alpha (FRα) is frequently expressed in ovarian high-grade serous carcinomas and is a clinically actionable biomarker targeted by FDA-approved mirvetuximab soravtansine (MIRV) for platinum-resistant disease with high expression (≥75% of tumor cells with ≥2+ staining). However, longitudinal variability in FRα expression remains poorly understood. We evaluated temporal FRα expression changes in paired ovarian cancer specimens.</div></div><div><h3>Methods</h3><div>We performed a retrospective study of epithelial ovarian malignancies at Mayo Clinic Florida (2013–2025) in patients with ≥2 tumor specimens available. Tumors were classified as FRα-positive when ≥75% of viable tumor cells showed moderate-to-strong (2+ and/or 3+) staining and categorized as concordant or discordant based on changes in FRα status. Associations between clinicopathologic variables and FRα variability were evaluated using Fisher exact and Kruskal–Wallis tests.</div></div><div><h3>Results</h3><div>Sixty-six patients (median age 66 years), most with advanced-stage high-grade serous carcinoma (65/66), had paired tumor specimens. FRα expression was concordant in 77.3% of cases and discordant in 22.7%. Negative-to-positive conversion occurred more frequently than positive-to-negative conversion (16.7% vs 6.1%). No significant associations were identified between FRα variability and clinicopathologic factors, including age, grade, stage, treatment setting, prior chemotherapy exposure, MIRV use, specimen type, sampling site, baseline FRα expression, or timing intervals. In patients treated with neoadjuvant chemotherapy, negative-to-positive conversion was numerically more frequent, although not statistically significant (25% vs 9%; <em>p</em> = 0.479).</div></div><div><h3>Conclusions</h3><div>FRα expression in ovarian carcinomas is generally stable over time, with concordance observed in most paired specimens. However, discordance in approximately one-quarter of cases suggests spatial and/or temporal tumor heterogeneity.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102179"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148737346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To biopsy or not to biopsy: More than an ultrasound is needed for postmenopausal bleeding evaluation","authors":"Sarah P. Huepenbecker,&nbsp;Katherine C. Fuh","doi":"10.1016/j.gore.2026.102182","DOIUrl":"10.1016/j.gore.2026.102182","url":null,"abstract":"","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102182"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148776633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A prospective algorithm for pre-operative risk stratification and individualized lymph node assessment in patients with endometrial intraepithelial neoplasia (EIN)","authors":"Pamela N. Peters,&nbsp;Lauren March,&nbsp;Georgia D. Smith,&nbsp;Elizabeth A. Bloom,&nbsp;Rebecca A. Previs,&nbsp;Angeles Alvarez Secord,&nbsp;Laura J. Havrilesky,&nbsp;Emma C. Rossi","doi":"10.1016/j.gore.2026.102177","DOIUrl":"10.1016/j.gore.2026.102177","url":null,"abstract":"<div><h3>Objectives</h3><div>The standard of care surgical management of endometrial intraepithelial neoplasia (EIN) is debated. Because EIN carries a 35–40% risk of underlying carcinoma, omission of lymph node sampling can result in incomplete staging. However, lymph node assessment for all patients results in overtreatment for those without cancer. We developed a preoperative risk-based algorithm to direct sentinel lymph node biopsy (SLNB) in EIN.</div></div><div><h3>Methods</h3><div>Patients with EIN planning hysterectomy were treated prospectively according to our algorithm. Patients with an endometrial stripe (EMS) ≥ 15 mm by pre-operative ultrasound or “EIN-cannot rule out carcinoma” on pathology underwent indocyanine green (ICG) injection and SLNB. Patients with EMS &lt; 15 mm underwent hysterectomy without SLNB.</div></div><div><h3>Results</h3><div>From August 2022–November 2023, 50 patients with EIN underwent hysterectomy. 48% (24/50) had cancer on final pathology, and 16% (8/50) had high-risk cancers (defined as meeting high-intermediate risk criteria for adjuvant radiation, high grade histology, or stage II or higher). SLNB was performed in 92% (22/24) of patients with cancer, including 100% (8/8) with high-risk cancers. Surgical decision making based on the algorithm had 92% sensitivity for achieving surgical staging of cancer and 100% sensitivity for staging high-risk cancers. The negative predictive value of the algorithm (NPV) to correctly identify patients without cancer was 89%.</div></div><div><h3>Conclusions</h3><div>A preoperative risk-based algorithm using EMS and pathology results has high sensitivity to identify and direct nodal assessment for patients with EIN at higher risk for endometrial cancer. The algorithm may allow for de-escalation and individualization of surgical treatment for EIN.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102177"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preclinical in vitro and in vivo activity of trastuzumab deruxtecan against ERBB2-mutated cervical carcinomas with low HER2 expression","authors":"Namrata Sethi,&nbsp;Sarah Ottum,&nbsp;Stefania Bellone,&nbsp;Cem Demirkiran,&nbsp;Natalia Buza,&nbsp;Pei Hui,&nbsp;Orazio De Tommasi,&nbsp;Luca Palmieri,&nbsp;Victoria M. Ettorre,&nbsp;Michelle Greenman,&nbsp;Tobias M. Hartwich,&nbsp;Elena Ratner,&nbsp;Alessandro D. Santin","doi":"10.1016/j.gore.2026.102171","DOIUrl":"10.1016/j.gore.2026.102171","url":null,"abstract":"<div><h3>Objective</h3><div>Somatic HER2 mutations occur in up to 6% of cervical cancer patients and are associated with poor prognosis. We explored the activity of trastuzumab deruxtecan (T-DXd) as a novel targeted therapy against HER2-mutated primary cervical cancer cell lines and xenografts with low HER2 expression.</div></div><div><h3>Methods</h3><div>HER2 expression was assessed by flow cytometry, while <em>ERBB2</em> mutations were identified by whole-exome sequencing. Cytotoxicity was measured by flow cytometry-based viability assays, and double-stranded DNA breaks were evaluated using anti-phosphorylated-histone H2AX antibody. Bystander effect was assessed by co-culturing HER2-S310F-mutated (CVX4) and non-mutated (CVX8) tumor cells. In vivo, efficacy was tested over 47 days in severe combined immunodeficient mice bearing CVX4-xenografts (<em>n</em> = 4 in each group).</div></div><div><h3>Results</h3><div>All eight primary cell lines available demonstrated low HER2 expression. CVX4 (HER2-S310F activating mutation) was significantly more sensitive to T-DXd than control antibody-drug conjugate (CTL-ADC) as demonstrated in the cytotoxicity experiments (<em>p</em> = 0.0036) and double-stranded DNA break assays (<em>p</em> = 0.0057). CVX3, a tumor with a HER2 mutation of unknown significance (HER2-E405D) and CVX8 (HER2-non-mutated) showed no difference in sensitivity to the ADC. T-DXd induced substantial bystander killing in the co-culture (<em>p</em> = 0.0223) while in vivo, a single retroorbital injection of T-DXd (4 mg/kg) was well tolerated and achieved remarkable growth inhibition compared with CTL-ADC in CVX4-xenografts (<em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>T-DXd was shown to be highly active against HER2-S310F-mutated cervical cancer cell lines and xenografts. T-DXd may represent a novel, effective therapeutic option for recurrent cervical cancer patients harboring mutations in the <em>ERBB2</em> gene, regardless of low HER2 expression.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102171"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult cervical embryonal rhabdomyosarcoma: a literature review of 41 adult cases with an illustrative aggressive case","authors":"Prapaporn Suprasert,&nbsp;Sopita Prasertpakdi,&nbsp;Tip Pongsuvareeyakul,&nbsp;Surapan Khunamornpong","doi":"10.1016/j.gore.2026.102169","DOIUrl":"10.1016/j.gore.2026.102169","url":null,"abstract":"<div><h3>Background</h3><div>Adult cervical embryonal rhabdomyosarcoma (ERMS) is an exceptionally rare malignant mesenchymal tumor, and evidence regarding its clinicopathologic characteristics, optimal management, and prognostic factors remains limited. We report an aggressive case of adult cervical ERMS and provide a contemporary review of the literature.</div></div><div><h3>Case presentation</h3><div>A 50-year-old woman presented with abnormal vaginal bleeding and was diagnosed with cervical ERMS following histopathologic and immunohistochemical evaluation. She underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy followed by adjuvant vincristine, actinomycin D, and cyclophosphamide (VAC) chemotherapy. Despite multimodal treatment, she developed rapid pelvic recurrence, progressive disease, and recurrent vaginal bleeding requiring palliative radiotherapy and died 13 months after diagnosis. To better characterize adult cervical ERMS, we reviewed English-language reports published between 2015 and 2026. Forty-one previously reported adult cases with sufficient clinical information were identified. The median age at diagnosis was 38 years, and the median tumor size was 5 cm. Most patients presented with stage I disease and were treated with surgery combined with chemotherapy, most commonly VAC-based regimens. Overall outcomes were generally favorable. Uncommon clinical presentations and associated conditions included uterine inversion, pregnancy-associated disease, cerebral venous sinus thrombosis, melanoma, and DICER1-associated alterations.</div></div><div><h3>Conclusion</h3><div>Adult cervical ERMS demonstrates substantial clinical heterogeneity. Although most reported patients achieve favorable outcomes with multimodal treatment, a subset may experience aggressive disease characterized by rapid recurrence and poor prognosis. Greater molecular characterization, particularly regarding DICER1-associated alterations, may improve risk stratification and support more individualized treatment strategies.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102169"},"PeriodicalIF":1.5,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KAT6B/A::KANSL1 uterine sarcoma – A case with recurrences following uterine morcellation and the development of primary cell line model","authors":"Lauren Chen,&nbsp;Jiahui Liu,&nbsp;Isabelle Nechala,&nbsp;Pooja Praveen Kumar,&nbsp;Carol Ewanowich,&nbsp;Melissa Levecchia,&nbsp;Christa Aubrey,&nbsp;Yangxin Fu,&nbsp;Cheng-Han Lee","doi":"10.1016/j.gore.2026.102168","DOIUrl":"10.1016/j.gore.2026.102168","url":null,"abstract":"<div><h3>Background</h3><div><em>KAT6B/A::KANSL1</em> uterine sarcoma has been recently recognized as a distinct type of uterine sarcoma displaying mixed endometrial stromal and smooth muscle features.</div></div><div><h3>Case presentation</h3><div>This report includes two cases of <em>KAT6B::KANSL1</em> uterine sarcoma with the first case presenting as a prolapsing uterine mass through the cervix. Histologic and molecular analysis performed on the biopsy confirmed the diagnosis of a <em>KAT6B/A::KANSL1</em> uterine sarcoma. The second is a <em>KAT6B::KANSL1</em> uterine sarcoma with multiple abdominal recurrences following uterine morcellation at hysterectomy for a presumed benign leiomyoma. Primary cell line models harboring <em>KAT6B::KANSL1</em> were successfully derived from both cases using fresh tumor tissue, with the aim to determine on whether their growth is estrogen-independent given their consistent strong estrogen receptor (ER) expression. However, in contrast to the respective parental tumors that were strongly ER-positive, the primary cell lines lacked ER expression; hence these cell line models cannot be used to evaluate the effects of estradiol on tumor growth.</div></div><div><h3>Conclusion</h3><div>Morcellation may increase the risk of recurrence for <em>KAT6B::KANSL1</em> uterine sarcoma. While it is feasible to establish primary cell lines from <em>KAT6B::KANSL1</em> uterine sarcoma, the <em>in vitro</em> cell line models do not retain ER expression.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"66 ","pages":"Article 102168"},"PeriodicalIF":1.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148477750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated ovarian metastasis in otherwise cervix-confined adenocarcinoma of the cervix: A rare clinical conundrum","authors":"Lauren M. Lim ,&nbsp;Sarah L. Speck ,&nbsp;Yingao Zhang ,&nbsp;Renata Urban ,&nbsp;Margaret I. Liang","doi":"10.1016/j.gore.2026.102120","DOIUrl":"10.1016/j.gore.2026.102120","url":null,"abstract":"<div><h3>Background</h3><div>Isolated ovarian metastasis in otherwise early-stage cervical cancer is an extremely rare clinical scenario. According to the 2018 International Federation of Gynecology and Obstetrics, ovarian involvement does not change staging of cervical cancer. However, ovarian metastasis is known to indicate a worse prognosis.</div></div><div><h3>Case presentation</h3><div>This report describes the clinical courses of two patients diagnosed with clinically early-stage adenocarcinoma of the cervix. Both patients had simple-appearing unilateral ovarian cysts, not concerning for metastasis. Each underwent primary surgical treatment, which then discovered unilateral ovarian metastasis of primary cervical cancer. Both patients were treated with adjuvant chemoradiation with cisplatin and pembrolizumab followed by pembrolizumab maintenance, per KEYNOTE A-18 as for Stage IVA disease. One patient’s tumor had PD-L1 combined positive score (CPS) &lt; 1, while the other patient had CPS of 12 but stopped immunotherapy early due to toxicity. Patients were disease-free 15–21 months following surgery.</div></div><div><h3>Conclusion</h3><div>Given the limited data with this unique clinical presentation, some oncologists may choose to treat these patients as locally advanced disease, whereas others may favor treating ovarian involvement as distant metastasis. Further investigation of the best management for these patients is needed.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102120"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148184935","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":"Intraoperative cytologic evaluation for ovarian tumors : Utility in low resource settings and a roadmap for adoption","authors":"Aaron Han","doi":"10.1016/j.gore.2026.102126","DOIUrl":"10.1016/j.gore.2026.102126","url":null,"abstract":"<div><div>Intraoperative pathology consultations play an important role in surgical management of oncologic patients. The benefits of frozen section, and cytologic samples are well known and studied. We reviewed the literature and describe a case that highlights some of the advantages and limitations of the cytologic method. We propose a step-wise approach to adopt cytology as the primary method for intraoperative assessment in low resource settings.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102126"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148185093","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":"Immunotherapy related organizing pneumonia mimicking metastatic progression in a patient with endometrial cancer: A case report","authors":"Hao Li ,&nbsp;Soe Paing Winn ,&nbsp;Yiqing Xu","doi":"10.1016/j.gore.2026.102115","DOIUrl":"10.1016/j.gore.2026.102115","url":null,"abstract":"<div><h3>Background</h3><div>Immune checkpoint inhibitor (ICI)–related pneumonitis is a well-recognized immune-related adverse event; however, its manifestation as organizing pneumonia (OP) mimicking metastatic disease remains underrecognized and presents a significant diagnostic challenge. Distinguishing true tumor progression from inflammatory processes is critical to avoid inappropriate treatment decisions.</div></div><div><h3>Case presentation</h3><div>A 60-year-old woman with high-grade serous endometrial carcinoma (pT2N2mi, pMMR) treated with adjuvant carboplatin, paclitaxel, and dostarlimab followed by maintenance dostarlimab. Nineteen months after diagnosis, routine surveillance CT and FDG-PET/CT demonstrated new bilateral FDG-avid pleural-based masses and pulmonary consolidations (SUV up to 8.9), raising strong concern for metastatic progression. Despite these findings, the patient remained asymptomatic, and serial circulating tumor DNA (ctDNA) testing was persistently negative. Initial bronchoscopy was non-diagnostic. A subsequent CT-guided core needle biopsy of a pleural lesion revealed organizing pneumonia with non-necrotizing granulomatous inflammation and no evidence of malignancy, establishing a diagnosis of ICI-related OP. Immunotherapy was discontinued, and corticosteroid therapy was initiated, resulting in complete radiographic resolution within two months.</div></div><div><h3>Conclusion</h3><div>ICI-related OP may present with mass-like, FDG-avid lesions that closely resemble metastatic disease. This case underscores the essential role of tissue biopsy in confirming the diagnosis and preventing misclassification of disease progression. Additionally, persistently negative ctDNA may serve as a supportive, noninvasive adjunct in distinguishing inflammatory processes from true malignancy.</div></div>","PeriodicalId":12873,"journal":{"name":"Gynecologic Oncology Reports","volume":"65 ","pages":"Article 102115"},"PeriodicalIF":1.3,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156278","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}