Case Reports and Clinical Series of Personalized Approaches in Gynecologic Oncology

Gynecologic oncology encompasses a biologically heterogeneous group of malignancies that continue to represent a major cause of cancer-related morbidity and mortality among women worldwide. Although large prospective trials and international collaborative studies have significantly improved the management of common gynecologic cancers, a substantial proportion of clinically relevant scenarios remain insufficiently investigated because of their rarity, molecular complexity, or highly individualized presentation. In this context, carefully documented case reports and small case series retain a critical role in advancing scientific knowledge and improving patient care.The modern era of gynecologic oncology is increasingly characterized by precision medicine, molecular stratification, targeted therapies, immunotherapy, fertility-preserving approaches, minimally invasive surgery, and integrated multidisciplinary management. As a consequence, clinicians are frequently confronted with uncommon clinical situations that are not adequately represented in conventional evidence-based guidelines. Rare histologic subtypes, unusual metastatic patterns, exceptional responses to treatment, resistance mechanisms, hereditary cancer syndromes, and complex surgical scenarios often require individualized decision-making based on limited available evidence. Publication of these experiences is therefore essential to disseminate clinically meaningful observations and stimulate further investigation.In recent years, the widespread implementation of next-generation sequencing and molecular tumor profiling has further transformed the landscape of gynecologic oncology. Increasing identification of BRCA1/2 mutations, homologous recombination deficiency, mismatch repair deficiency, POLE mutations, HER2 amplification, NTRK fusions, and other actionable molecular alterations has generated new therapeutic opportunities, particularly in ovarian and endometrial cancers. However, many molecularly defined subgroups remain rare, and their optimal management frequently derives from anecdotal experiences or small institutional cohorts. High-quality case-based literature may therefore provide valuable insights into treatment efficacy, resistance pathways, toxicity profiles, and long-term outcomes in real-world settings.At the same time, important advances in surgical oncology have expanded the complexity and personalization of gynecologic cancer treatment. Fertility-sparing surgery in carefully selected patients, ultra-radical cytoreductive procedures, robotic and minimally invasive approaches, sentinel lymph node mapping, pelvic exenteration, and multidisciplinary management of recurrent disease all represent areas where institutional experiences and small series may substantially contribute to clinical knowledge. Similarly, unusual perioperative complications, innovative reconstructive strategies, and management of rare clinical scenarios are often best described through detailed case-based reports.Hereditary cancer syndromes constitute another rapidly evolving field within gynecologic oncology. The increasing integration of germline and somatic genetic testing into routine clinical practice has created new challenges regarding surveillance, preventive surgery, fertility preservation, hormone replacement therapy, psychosocial implications, and long-term survivorship. Patients carrying BRCA mutations, Lynch syndrome, RAD51C/RAD51D, BRIP1, PALB2, and other moderate-penetrance mutations frequently present complex management dilemmas that are insufficiently addressed in large trials. Detailed clinical reports and small case series may therefore provide practical information for clinicians managing these patients in everyday practice.Moreover, several rare gynecologic malignancies continue to suffer from profound evidence gaps due to their low incidence. Tumors such as ovarian carcinosarcoma, mesonephric-like adenocarcinoma, neuroendocrine carcinomas, gestational trophoblastic neoplasia, sex cord-stromal tumors, malignant germ cell tumors, vulvovaginal melanomas, and other uncommon entities are rarely included in randomized studies. Consequently, collaborative publication of institutional experiences and multicenter small series may significantly improve understanding of disease biology, prognostic factors, and therapeutic approaches.The proposed Research Topic also recognizes the increasing relevance of translational and technological innovation in gynecologic oncology. Artificial intelligence-assisted imaging, radiomics, liquid biopsy, molecular diagnostics, digital pathology, and integrated genomic analysis are progressively entering clinical practice. Case-based reports describing successful or challenging applications of these technologies may help bridge the gap between translational research and real-world implementation.Importantly, case reports and small series remain uniquely valuable for identifying early signals of innovation. Historically, several major oncologic advances—including novel therapeutic indications, unexpected drug toxicities, hereditary syndromes, and new pathologic entities—were initially recognized through individual clinical observations. In the current era of personalized oncology, this role may become even more important, as increasingly fragmented molecular subgroups reduce the feasibility of traditional large-scale studies for many clinical scenarios.This Research Topic therefore aims to provide an international platform dedicated to high-quality clinical observations, rare tumor experiences, translational insights, and multidisciplinary management strategies in gynecologic oncology. The collection seeks to promote rigorous and educational case-based publications capable of generating hypotheses, supporting collaborative research networks, and ultimately improving patient outcomes.The Research Topic would welcome submissions including, but not limited to:Rare Gynecologic Tumors· Small cell carcinoma of the ovary· Mesonephric and mesonephric-like carcinomas· Ovarian carcinosarcoma· Müllerian adenosarcoma· Clear cell and mucinous rare variants· Gestational trophoblastic neoplasia· Sex cord-stromal tumors· Germ cell tumors· Neuroendocrine gynecologic malignanciesPrecision Oncology and Molecular Profiling· BRCA-associated tumors· Homologous recombination deficiency (HRD)· Rare actionable mutations· Exceptional responses to PARP inhibitors· Immunotherapy in rare histologies· Molecular tumor board experiences· Resistance mechanisms to targeted therapiesSurgical Innovation and Complex Management· Ultra-radical surgery· Fertility-sparing surgery in rare tumors· Cytoreductive surgery in uncommon settings· Sentinel lymph node mapping in unusual contexts· Multidisciplinary pelvic exenteration· Robotic and minimally invasive approaches in selected complex casesHereditary Cancer Syndromes· Lynch syndrome-related gynecologic tumors· BRCA mutation carriers· Moderate penetrance mutations· Rare hereditary syndromes· Preventive surgery and surveillance experiences· Psychosocial and reproductive implicationsExceptional Clinical Scenarios· Pregnancy-associated gynecologic cancers· Very young or elderly patients· Unusual metastatic patterns· Long-term survivors· Rare treatment toxicities· Paraneoplastic syndromes· Autoimmune complicationsTranslational and Diagnostic Insights· Novel biomarkers· Radiomics and AI-assisted diagnosis· Unusual imaging-pathology correlations· Liquid biopsy applications· Pathologic diagnostic challenges· Integration of genomics into routine practiceArticle TypesThe Topic would particularly encourage:· Case Reports· Small Case Series· Clinical Images· Mini Reviews linked to rare entities· Translational case-based studies· Multidisciplinary management reportsBy collecting and disseminating these experiences, the Research Topic aims to strengthen collaboration among gynecologic oncologists, pathologists, geneticists, translational researchers, radiologists, reproductive specialists, and allied healthcare professionals worldwide, ultimately contributing to a more individualized and evidence-informed approach to gynecologic cancer care. Topic editors: Robert Fruscio, Alice Bergamini Source: https://www.frontiersin.org/research-topics/81786/case-reports-and-clinical-series-of-personalized-approaches-in-gynecologic-oncology