Case Report
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jul 24, 2019; 10(7): 247-255
Published online Jul 24, 2019. doi: 10.5306/wjco.v10.i7.247
Pseudo- or real progression? An ovarian cancer patient under nivolumab: A case report
Mona Passler, Eliane T Taube, Jalid Sehouli, Klaus Pietzner
Mona Passler, Jalid Sehouli, Klaus Pietzner, Department of Gynecology, Competence Center for Ovarian Cancer (EKZE), Charité - University Medicine, Berlin 13353, Germany
Eliane T Taube, Institute of Pathology, Charité University Hospital, Berlin 10117, Germany
Author contributions: Passler M reviewed the literature, contributed to manuscript drafting and was responsible for the submission process; Eliane T Taube was responsible for the pathological findings and review of the literature; Sehouli J and Pietzner K were the attending doctors and responsible for important intellectual content.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Mona Passler, Junior Researcher, Department of Gynecology, Competence Center for Ovarian Cancer (EKZE), Charité - University Medicine, Augustenburger Platz 1, Berlin 13353, Germany.
Telephone: +49-157-59552338
Received: February 28, 2019
Peer-review started: March 4, 2019
First decision: April 11, 2019
Revised: July 8, 2019
Accepted: July 16, 2019
Article in press: July 17, 2019
Published online: July 24, 2019
Core Tip

Core tip: Clinicians have to be aware of the phenomenon of pseudoprogression despite its rather rare occurrence. As both- pseudo-progression and real progression present with an increase in tumor size, the only certain way to differentiate between them is the occurrence of infiltrating growth. While the increase of tumor size in pseudoprogression can be explained by benign growth due to immune cell infiltration and edema, only malign growth of a real progression has the ability to infiltrate other tissues. When in doubt whether a pseudoprogression has occurred, we suggest cautious continuation of checkpoint-inhibition paired with corticoids to lower adverse effects if necessary.