Subject(s)
Carcinosarcoma/pathology , Carcinosarcoma/surgery , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Pilomatrixoma/pathology , Pilomatrixoma/surgery , Carcinosarcoma/drug therapy , Carcinosarcoma/radiotherapy , Combined Modality Therapy , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Humans , Male , Neoplasm Recurrence, Local , Pilomatrixoma/drug therapy , Pilomatrixoma/radiotherapy , Young AdultABSTRACT
We report the case of a 66-year-old patient with a pilomatrix carcinoma from the right submandibular region with pulmonary and cerebral metastases. The histological confirmation of the diagnosis has been based on the biopsy of the submandibular tumefaction which was rapidly growing. We tried at first a doxorubicine and cisplatine chemotherapy because of the considerable locoregional extension and the existence of pulmonary metastases. The patient response to three cures of chemotherapy was spectacular with a partial clinical response (75%) and a partially cleaned-up chest observed in the radiological evaluation. In the 5th cycle of chemotherapy following the same protocol, the patient presented a relapse with cerebral metastases. The patient received hypofractionated radiotherapy on the brain followed by etoposide and cisplatine chemotherapy, then oral vinorelbine. The patient died of progressive disease after 32 weeks.
Subject(s)
Facial Neoplasms/pathology , Pilomatrixoma/secondary , Skin Neoplasms/pathology , Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Brain Neoplasms/drug therapy , Brain Neoplasms/radiotherapy , Brain Neoplasms/secondary , Cisplatin/administration & dosage , Combined Modality Therapy , Doxorubicin/administration & dosage , Etoposide/administration & dosage , Facial Neoplasms/diagnosis , Facial Neoplasms/drug therapy , Fatal Outcome , Humans , Lung Neoplasms/drug therapy , Lung Neoplasms/secondary , Male , Pilomatrixoma/diagnosis , Pilomatrixoma/drug therapy , Pilomatrixoma/radiotherapy , Skin Neoplasms/diagnosis , Skin Neoplasms/drug therapy , Vinblastine/administration & dosage , Vinblastine/analogs & derivatives , VinorelbineABSTRACT
Pilar tumor is a rare neoplasm arising from the external root sheath of the hair follicle and is most commonly observed on the scalp. These tumors are largely benign, often cystic, and are characterized by trichilemmal keratinization. Wide local excision has been the standard treatment. Recent reports have described a rare malignant variant with an aggressive clinical course and a propensity for nodal and distant metastases which, therefore, merits aggressive treatment. In this report, we present a case of malignant pilar tumor of the scalp with multiple nodal metastases at presentation. Diagnostic and therapeutic considerations, in the form of adjuvant radiotherapy, are subsequently discussed.
Subject(s)
Hair Diseases/pathology , Pilomatrixoma/secondary , Scalp , Skin Neoplasms/pathology , Female , Hair Diseases/radiotherapy , Hair Diseases/surgery , Humans , Lymphatic Metastasis , Middle Aged , Pilomatrixoma/radiotherapy , Pilomatrixoma/surgery , Radiotherapy, Adjuvant , Skin Neoplasms/radiotherapy , Skin Neoplasms/surgeryABSTRACT
CASE REPORT: A 72-year-old male patient developed a locally recurrent pilomatrix carcinoma (PC) of the right upper shank. Within a 2-year period he also developed bilateral pulmonary as well as inguinal, cervical and paraaortic lymph node metastases. After external-beam radiation therapy (EBRT) alone, sole interstitial high-dose-rate (HDR) brachytherapy (BRT) or postoperative EBRT with interstitial HDR-BRT boost, the patient demonstrated regressive or stable disease at the lymphatic sites. Systemic chemotherapy with intravenous paclitaxel failed to assure a substantial pulmonary response. In the course of the disease after 28 months pulmonary progression has led to continuing clinical deterioration. CONCLUSION: In accordance with literature data the hitherto course of this case corroborates that radiation therapy (RT) modalities can play an important role in the treatment of PC.
