RESUMO
Although smoothened inhibitors (SMOi) have demonstrated efficacy in the management of basal cell carcinoma, no guidelines are available on how to utilize SMOi in the treatment of Gorlin syndrome (GS). This review's objective is to assess the clinical response to SMOi in GS, provide practical guidance for clinicians, and identify areas for future research. Through comprehensive searches of previous publications and expert opinion, this review demonstrates that intermittent dosing of SMOi and daily dosing have similar efficacy. While the adverse events of SMOi may result in their discontinuation during treatment of GS, intermittent dosing may improve compliance.
Assuntos
Síndrome do Nevo Basocelular , Piridinas , Neoplasias Cutâneas , Receptor Smoothened , Síndrome do Nevo Basocelular/tratamento farmacológico , Humanos , Receptor Smoothened/antagonistas & inibidores , Neoplasias Cutâneas/tratamento farmacológico , Piridinas/administração & dosagem , Piridinas/efeitos adversos , Piridinas/uso terapêutico , Administração Oral , Anilidas/administração & dosagem , Anilidas/efeitos adversos , Anilidas/uso terapêutico , Resultado do Tratamento , Masculino , Feminino , Antineoplásicos/efeitos adversos , Antineoplásicos/administração & dosagem , Quinazolinas/administração & dosagem , Quinazolinas/uso terapêutico , Quinazolinas/efeitos adversos , Compostos de Bifenilo/administração & dosagem , Esquema de Medicação , Benzimidazóis , Compostos de FenilureiaRESUMO
Introduction: Cutaneous metastasis of urothelial carcinoma is a rare occurrence, accounting for a small percentage of skin metastases in cancer patients. This case presentation highlights the importance of considering cutaneous metastasis in patients with a history of urologic malignancy presenting with new dermal nodules. Case presentation: A 79-year-old male with a history of papillary urothelial carcinoma of the bladder and metastasis to the rectum presented with a painful and pruritic rash in the right inguinal region. Physical examination revealed firm papulonodules forming confluent, hyperpigmented to violaceous plaques. A punch biopsy confirmed the diagnosis of cutaneous metastasis of urothelial carcinoma based on histopathological and immunohistochemical findings. Conclusion: While cutaneous metastasis is uncommon in urothelial carcinoma, early recognition and diagnosis are crucial in guiding patient management and setting realistic expectations regarding prognosis. Timely identification of cutaneous lesions can help facilitate appropriate treatment decisions and discussions of goals of care.