1. Pembrolizumab in a Patient With a Metastatic CASTLE Tumor of the Parotid
- Author
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Lisa Lorenz, Joscha von Rappard, Walter Arnold, Nicole Mutter, Udo Schirp, Andreas Scherr, and Andreas Werner Jehle
- Subjects
PD-L1 ,0301 basic medicine ,Cancer Research ,Pathology ,medicine.medical_specialty ,medicine.medical_treatment ,Case Report ,Pembrolizumab ,carcinoma ,lcsh:RC254-282 ,extrathyroidal ,03 medical and health sciences ,0302 clinical medicine ,stomatognathic system ,Carcinoma ,Medicine ,Pleural Carcinomatosis ,biology ,business.industry ,CD117 ,Thyroid ,CASTLE ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,medicine.disease ,Parotid gland ,Radiation therapy ,checkpoint inhibitor ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,parotid ,030220 oncology & carcinogenesis ,Monoclonal ,biology.protein ,immunotherapy ,thymus-like ,business - Abstract
Carcinoma showing thymus-like elements (CASTLE) is a rare tumor, most commonly found in the thyroid gland. Here we report a case of CASTLE tumor localized to the parotid gland, recognized in retrospect after a late manifestation of symptomatic pleural carcinomatosis. The original tumor in the parotid gland was treated by surgery followed by radiotherapy. Ten years later, a metastatic disease with recurrent pleural effusions occurred. Pleural carcinomatosis was strongly positive for CD5, CD117, and p63 as was the original tumor of the parotid, which allowed the diagnosis of a CASTLE tumor. Additionally, the pleural tumor expressed high levels of programmed death ligand 1 (PD-L1), and the patient underwent treatment with the monoclonal PD-L1 inhibitor pembrolizumab achieving a partial remission. To the best of our knowledge, this is the first patient with a metastatic CASTLE tumor treated with a PD-L1 inhibitor.
- Published
- 2019