Assuntos
Carcinossarcoma/patologia , Carcinossarcoma/cirurgia , Neoplasias de Cabeça e Pescoço/patologia , Neoplasias de Cabeça e Pescoço/cirurgia , Pilomatrixoma/patologia , Pilomatrixoma/cirurgia , Carcinossarcoma/tratamento farmacológico , Carcinossarcoma/radioterapia , Terapia Combinada , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Recidiva Local de Neoplasia , Pilomatrixoma/tratamento farmacológico , Pilomatrixoma/radioterapia , Adulto JovemRESUMO
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.
Assuntos
Neoplasias Faciais/patologia , Pilomatrixoma/secundário , Neoplasias Cutâneas/patologia , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias Encefálicas/tratamento farmacológico , Neoplasias Encefálicas/radioterapia , Neoplasias Encefálicas/secundário , Cisplatino/administração & dosagem , Terapia Combinada , Doxorrubicina/administração & dosagem , Etoposídeo/administração & dosagem , Neoplasias Faciais/diagnóstico , Neoplasias Faciais/tratamento farmacológico , Evolução Fatal , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Masculino , Pilomatrixoma/diagnóstico , Pilomatrixoma/tratamento farmacológico , Pilomatrixoma/radioterapia , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/tratamento farmacológico , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , VinorelbinaRESUMO
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.
Assuntos
Doenças do Cabelo/patologia , Pilomatrixoma/secundário , Couro Cabeludo , Neoplasias Cutâneas/patologia , Feminino , Doenças do Cabelo/radioterapia , Doenças do Cabelo/cirurgia , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Pilomatrixoma/radioterapia , Pilomatrixoma/cirurgia , Radioterapia Adjuvante , Neoplasias Cutâneas/radioterapia , Neoplasias Cutâneas/cirurgiaRESUMO
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.