Neoadjuvant bleomycin, etoposide, and cisplatin in adult neuroblastoma arising from the broad ligament of the uterus.
BACKGROUND
A case of primary neuroblastoma arising from the broad ligament with excellent response to neoadjuvant bleomycin, etoposide, and cisplatin (BEP) is reported.


METHODS
A 48-year-old woman, G0, who presented with acute renal failure, an enlarged pelvic mass, and abdominal pain was diagnosed with adult neuroblastoma arising from the broad ligament of the uterus. She received three cycles of neoadjuvant therapy consisting of bleomycin, etoposide, and cisplatin (BEP) given every 3 weeks and had an excellent initial response. She then underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy, and appendectomy, with pathologic analysis revealing small residual disease on the broad ligament of the uterus and omentum. The patient died of recurrent disease 20 months after her initial diagnosis.


CONCLUSIONS
The clinical management of cancer in the broad ligament of the uterus must be tailored to the pathologic diagnosis. Although our patient had an excellent initial response to BEP, further study is needed to identify a treatment that can reduce recurrences and improve clinical outcomes.
Milam
Michael R
MR
Department of Gynecologic Oncology, Unit 1362, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
Gabel
Stephanie F
SF
Milam
R Ashley
RA
Liu
Jinsong
J
Ramirez
Pedro T
PT
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001956:Broad Ligament; D002945:Cisplatin / Q000008:administration & dosage; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009447:Neuroblastoma / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*
D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin