Client Story

Metastatic Kidney Cancer: From Unknown Primary Diagnosis

A father gives his son a piggyback ride.

Presentation

A 57-year-old father of four presented with neck swelling and sought expert guidance and diagnostic clarity from PHM after feeling frustrated with his healthcare provider and the system.

Biopsy revealed metastatic poorly differentiated carcinoma but could not determine primary site of cancer.  

Additional molecular profiling ordered by provider on the biopsy tissue did not reveal primary cancer site.  

Disease quickly progressed on 1st line treatment (carboplatin/paclitaxel); pivoted to pembrolizumab monotherapy.  

PHM Actions

PHM Care Team reviewed surgical history, pathology, and outside molecular profiling reports.

PHM Care team determined results could be suggestive of kidney cancer.  

Coordinated tumor tissue of origin testing (CancerTypeID) which quickly confirmed kidney cancer (96% probability).  

Optimized local care by shifting from previous local provider to leading expert provider at UCSF.  

Arranged second opinion consult with international kidney cancer KOL; confirmed cancer primary site and appropriate treatment plan for kidney cancer 1st line standard of care. 

Outcome

Definitive diagnosis with a new treatment plan was achieved by course correcting original indeterminate diagnosis and subsequent ineffective treatment path.  

Further characterized tumor and identified additional treatment options as well as plans for next line of therapy should 1st line treatment be unsuccessful. 

The PHM Difference

Identified correct diagnosis and engaged a provider that offered appropriate immediate treatment plan.  

“We are in a much better place than we were a month ago, thanks to you. You’ve put us on a good path, we feel really good here.” 

A mother and daughter laugh in nature.

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