Exceptional response to chemotherapy followed by concurrent radiotherapy and immunotherapy in a male with primary retroperitoneal serous Adenocarcinoma: a case report and literature review.

BACKGROUND: Primary retroperitoneal serous adenocarcinoma (PRSA) is an extremely uncommon malignancy exclusively reported in females. Due to the rarity of the disease, it is difficult to establish a standardized treatment. CASE PRESENTATION: We describe a unique case of PRSA in a 71-year-old male who presented with right-sided lower back pain and numbness. Magnetic resonance imaging identified a mass invading the adjacent psoas muscle and twelfth rib. Tissue biopsy confirmed poorly differentiated PRSA. Patient was initially treated with neoadjuvant carboplatin and paclitaxel chemotherapy regimen. This resulted in complete radiological resolution of the tumor. However, 12 weeks later, rapid recurrence was noted on follow-up CT scan. The patient was then treated with external radiotherapy with concurrent nivolumab, an anti-PD-1 antibody. The patient displayed a positive response to treatment with reduction in primary tumor and metastases and had a sustained disease control. CONCLUSION: Treatment with radiotherapy in combination with anti-PD-1 antibody could be an effective modality of management for PRSA.

Patients' Compliance With Quarantine Requirements for Exposure or Potential Symptoms of COVID-19.

Reducing Coronavirus disease 2019 (COVID-19) transmission relies on people quarantining after exposure to COVID-19 or if they experience COVID-19 symptoms, and isolating from others if COVID-19 positive. Quarantine and isolation last 10 to 14 days and can be state-mandated; however, the level of compliance is unknown. The University of Hawai'i Department of Family Medicine clinic called patients instructed by our physicians to quarantine for exposure risk or symptoms of potential COVID-19 infection between March 15, 2020, and April 15, 2020. None of the patients tested positive for COVID-19. Sixty-nine of 90 (77%) patients completed follow-up calls and self-reported whether they had stayed home. Of these 69 patients, 32 (46%) broke quarantine to buy groceries (36%), work (9%), visit others (6%), or for other reasons (12%). For patients living alone, 8 of 11 (73%) left home to buy groceries. For employed patients, 6 of 39 (15%) returned to work during their quarantine period. Nearly half of our patients did not quarantine for the entire period. Many persons left home to buy food or to work. Strong public health messaging is needed to educate communities about the requirement to quarantine. Clinicians can help by asking patients about social and financial ability to quarantine, schedule follow-up appointments to remind patients to stay home, and link patients to food programs, financial assistance, and other community resources to successfully quarantine and prevent COVID-19 transmission.