Radiant light symbolizing cancer remission through a complex network of tissues.

Beating the Odds: A Rare Cancer Success Story

Lena Voss in Health & Wellness July 2025 • 4 min read.

"Discover how radiotherapy and oral chemotherapy led to complete remission of a rare retroperitoneal transitional cell carcinoma in this inspiring case report."

In the world of oncology, where battles against rare and aggressive cancers often meet with limited success, a recent case report offers a beacon of hope. Primary retroperitoneal transitional cell carcinoma (TCC) is an exceptionally uncommon malignancy, notorious for its poor prognosis. However, a compelling case from Japan details a remarkable victory against this formidable disease.

This case revolves around a 68-year-old woman who presented with alarming symptoms, ultimately diagnosed with primary retroperitoneal TCC. The rarity and aggressive nature of this cancer meant conventional treatments offered little promise. Yet, through a carefully orchestrated combination of radiotherapy and oral chemotherapy, she achieved what many deemed impossible: complete remission.

This article explores the intricate details of this case, shedding light on the diagnostic journey, the innovative treatment strategy, and the long-term triumph over this rare cancer. It underscores the potential of combined therapies and offers a renewed sense of optimism for those facing similar battles.

The Diagnostic Journey and Treatment Strategy

Radiant light symbolizing cancer remission through a complex network of tissues.

The patient's journey began with the sudden onset of bloody stool, leading to an initial colonoscopy that only revealed hemorrhoids. Further investigation via abdominal ultrasonography uncovered a 7cm mass in the left iliac fossa. A pelvic examination confirmed a hard, unmovable mass on the left side of the uterus. Elevated levels of serum CA125, a tumor marker, added to the growing concern. Subsequent CT scans and MRI pinpointed a 5cm x 7cm x 7cm mass in the left pelvic wall, with no evidence of nodal or distant metastases.

Laparotomy revealed a retroperitoneal mass extending into the lesser pelvis, encasing the left ovary and uterine tube. Due to the inability to dissect the mass, only an incision biopsy was performed. Histological analysis confirmed a transitional cell carcinoma (TCC), devoid of ovarian tissue. Negative cytology of ascites and unremarkable findings from cystoscopy and intravenous pyelography led to the diagnosis of primary retroperitoneal TCC.

Following the diagnosis, the treatment strategy evolved through several phases:

Initial Chemotherapy: Oral tegafur-uracil (UFT) was initiated but proved ineffective.
Combined Radiotherapy and Chemotherapy: Radiotherapy was combined with UFT, delivering a total dose of 50Gy in 25 fractions.
Monitoring and Adjustment: Regular monitoring and dosage adjustments were crucial due to side effects like leucopenia.

The integrated approach of radiotherapy and chemotherapy proved to be the turning point. Twenty months after starting radiotherapy, imaging revealed near-complete remission of the tumor. Regular follow-ups confirmed the sustained remission, with no recurrence detected even after ten years. The patient did later develop breast cancer, requiring further treatment, but the retroperitoneal TCC remained in remission. This case emphasizes the importance of aggressive, multimodal treatment strategies in combating rare and aggressive cancers.

A Beacon of Hope for Rare Cancer Treatment

This case report provides valuable insights into the successful management of primary retroperitoneal TCC, an otherwise aggressive and rare malignancy. The combination of radiotherapy and oral chemotherapy, along with meticulous monitoring and dosage adjustments, played a pivotal role in achieving complete remission. While more research is needed, this case suggests that aggressive, multimodal approaches can offer hope for patients facing rare and challenging cancers. The long-term success underscores the importance of continuous surveillance and adaptability in treatment strategies.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1308/003588413x13511609955058, Alternate LINK

Title: Complete Remission Of Primary Retroperitoneal Transitional Cell Carcinoma After Radiotherapy And Oral Chemotherapy: A Case Report

Subject: General Medicine

Journal: The Annals of The Royal College of Surgeons of England

Publisher: Royal College of Surgeons of England

Authors: K Ichinohe, M Ijima, T Usami, S Baba

Published: 2013-03-01

Everything You Need To Know

What is primary retroperitoneal transitional cell carcinoma (TCC), and why is it considered so rare and challenging to treat?

Primary retroperitoneal transitional cell carcinoma (TCC) is an exceptionally uncommon malignancy located in the retroperitoneum, the space behind the abdominal cavity's lining. Its rarity often leads to a poor prognosis due to limited research and experience in treating it. Unlike bladder TCC, which is more common, primary retroperitoneal TCC originates outside the urinary tract, making diagnosis and treatment more complex.

What specific treatment approach, including drugs and methods, led to the successful remission of the primary retroperitoneal transitional cell carcinoma (TCC) in the patient described?

In this particular case, the patient received a combination of radiotherapy and oral chemotherapy using tegafur-uracil (UFT). Radiotherapy was administered in 25 fractions, delivering a total dose of 50Gy. The oral chemotherapy, UFT, was given alongside the radiotherapy. This combined approach aimed to target the transitional cell carcinoma (TCC) cells both locally and systemically.

What were the key diagnostic steps and findings that led to the identification of primary retroperitoneal transitional cell carcinoma (TCC) in this patient, and what initial symptoms prompted the investigation?

Serum CA125 levels were elevated, which pointed towards a potential malignancy. Imaging techniques, including abdominal ultrasonography, CT scans, and MRI, were crucial in identifying and locating the mass in the left pelvic wall. A colonoscopy was initially performed due to bloody stool symptoms, but only revealed hemorrhoids. The definitive diagnosis came from an incision biopsy of the retroperitoneal mass, followed by histological analysis confirming transitional cell carcinoma (TCC).

Beyond the combined therapy, what role did monitoring and adjustments play in the successful outcome, and what other health issues did the patient face during the follow-up period?

While this case demonstrated a successful outcome using combined radiotherapy and oral chemotherapy (UFT), the effectiveness of the treatment was also carefully monitored for side effects, such as leucopenia. Regular adjustments to the treatment plan were made based on the patient's response and tolerance. The patient later developed breast cancer, which required separate treatment, but her retroperitoneal transitional cell carcinoma (TCC) remained in remission.

What are the broader implications of this successful case for treating other rare and aggressive cancers, and what further research is needed to improve outcomes for patients with primary retroperitoneal transitional cell carcinoma (TCC)?

The success of combined radiotherapy and oral chemotherapy (UFT) in this case suggests that aggressive, multimodal treatment strategies can be effective against rare and aggressive cancers like primary retroperitoneal transitional cell carcinoma (TCC). It highlights the importance of continuous monitoring and adaptability in treatment approaches. However, since this is just one case, more research is needed to determine the broader applicability and optimize treatment protocols for similar cases. Further investigation into the molecular characteristics of such rare tumors could also lead to more targeted therapies.