Chemotherapy of rare skin adnexal tumors: a review of literature.

Malignant skin adnexal tumors are rare neoplasms which are derived from adnexal epithelial structures of the skin: hair follicle, or sebaceous, apocrine or eccrine glands. Among them, eccrine porocarcinoma is the most frequent, with an aggressive behavior compared to other more common forms of non-melanoma skin cancer. Only few reports describe the treatment of metastatic adnexal tumors, and there is no consensus about the better strategy of chemotherapy. Given the few cases and the absence of randomized clinical trials, it is important to collect clinical experiences on these tumors. Most of these adenocarcinomas are very aggressive and also chemoresistant, and only a targeted-therapy could have an impact on patient survival. Therefore, further studies on the biology of these diseases are necessary. The purpose of the present review is to discuss the treatment of malignant neoplasms of cutaneous adnexae and to suggest some future therapeutic options based on targeted-therapy.

Prevention of osteonecrosis of the jaw in patients with bone metastases treated with bisphosphonates.

Bisphosphonates (BPs) are potent inhibitors of osteoclast-mediated bone resorption and are widely used in the treatment of bone metastases. Osteonecrosis of the jaw (ONJ) is the worst side-effect related to BP use. At our Center, we have implemented internal guidelines regarding the management of patients with bone metastases from solid tumors. Our analysis includes 200 patients affected by solid tumors with bone metastases who received zoledronic acid. They underwent a baseline mouth assessment to evaluate their dental conditions and to perform dental care; a dental follow-up was performed every six months. All patients received calcium and vitamin D daily. Dental examination and application of preventive measures led to a total reduction in ONJ in our patients treated with zoledronic acid. The keystone in management of ONJ is prevention, and the risk of developing ONJ during treatment with zoledronic acid is reduced by implementing preventive measures.