The abscopal effect is defined as the systemic regression of distant neoplastic lesions induced by localized treatment. Although the first case reports date back to the beginning of the twentieth century, it remains a very rare event. In recent years, research and reporting on the subject has increased thanks to the development of new immune-checkpoint inhibitors (ICIs) and stereotactic body radiotherapy, as a consequence of molecular and clinical synergism. This work describes an extremely particular presentation of metastatic laryngeal cancer, with mediastinal abdominal nodes and bone progressive disease after PD-1 inhibitor failure, which resulted in reductions of bone pain and abdominal and thoracic lymphadenopathies and an improvement in clinical conditions after treatment with concurrent palliative radiotherapy on the bulky mediastinal node and ICI beyond progression, configuring an important abscopal response.
The abscopal effect (AbE) is defined as radiation-induced shrinkage of distant, non-treated, neoplastic lesions and it is considered the best clinical picture of the efficient immune stimulation by irradiation. The first report about abscopal tumor regression upon radiotherapy dates back to the beginning of the 20th century. The growing preclinical and clinical synergism between radiation and immunotherapy gave birth the purpose to more easily reproduce the abscopal effect, nevertheless, it is still rare in clinical practice. In this review we summarize immunological modulation of radiotherapy, focusing on the well-balanced equilibrium of tumor microenvironment and how radio-immunotherapy combinations can perturb it, with particular attention on head and neck squamous cell cancer. Finally, we investigate future perspectives, with the aim to “tailor” the abscopal effect to the patient.
Endometrial endometrioid adenocarcinoma is the most common histology in gynecological malignancies. Most women present loco-regional relapsing or peritoneal and liver involvement within three years from diagnosis. However long-survivor patients may be affected by atypical disease evolutions. Here we describe an extremely rare case of retroauricular metastasis in a patient affected by endometrial endometrioid adenocarcinoma, who had a total abdominal hysterectomy and bilateral salpingo-oophorectomy six years earlier and subsequent salvage surgery three years later for loco-regional relapsed disease.
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