JOURNAL of
ONCOLOGICAL
SCIENCES

CASE REPORT

Metastatic Laryngeal Squamous Cell Carcinoma Progressing with Subcutaneous Skin Metastasis Following Chemotherapy and Pembrolizumab Combination Treatment
Received Date : 13 Apr 2024
Accepted Date : 19 Jun 2024
Available Online : 12 Aug 2024
Doi: 10.37047/jos.2024-103394 - Article's Language: EN
Journal of Oncological Sciences. 2024;10(3):158-62
This is an open access article under the CC BY-NC-ND license
ABSTRACT
The incidence of cutaneous metastasis of solid tumors is rare. Breast cancer is commonly associated with skin metastases. The frequency of cutaneous metastasis of lung and larynx cancers is high in men. The most common site of cutaneous metastases is the anterior thorax, followed by the abdomen, head and neck, scalp, and extremities. The prognosis of patients with cutaneous metastases is poor. The median life expectancy after skin metastasis development in most patients is 6 months. This study reported a 55-year-old patient diagnosed with metastasized laryngeal squamous cell carcinoma in which 90% of cells exhibited PD-L1 expression. After treatment with the combination of pembrolizumab and cisplatin-fluorouracil chemotherapy, the patient developed multiple subcutaneous skin metastases on the lower extremities and back after the fourth cycle. The review of previous scientific literature in the English language revealed only 16 subcutaneous skin metastasis cases. However, the development of skin metastases after immunotherapy has not been previously reported. Thus, visceral metastases may progress rapidly in patients with skin metastases, contributing to poor prognosis.
REFERENCES
  1. Igissin N, Zatonskikh V, Telmanova Z, Tulebaev R, Moore M. Laryngeal cancer: epidemiology, etiology, and prevention: a narrative review. Iran J Public Health. 2023;52(11):2248-2259. [Crossref]  [PubMed]  [PMC] 
  2. Ciolofan MS, Vlăescu AN, Mogoantă CA, et al. Clinical, histological and immunohistochemical evaluation of larynx cancer. Curr Health Sci J. 2017;43(4):367-375. [PubMed]  [PMC] 
  3. Markou K, Christoforidou A, Karasmanis I, et al. Laryngeal cancer: epidemiological data from Νorthern Greece and review of the literature. Hippokratia. 2013;17(4):313-318. [PubMed]  [PMC] 
  4. Garavello W, Ciardo A, Spreafico R, Gaini RM. Risk factors for distant metastases in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 2006;132(7):762-766. [Crossref]  [PubMed] 
  5. Souza BCE, Miyashiro D, Pincelli MS, Sanches JA. Cutaneous metastases from solid neoplasms - literature review. An Bras Dermatol. 2023;98(5):571-579. [Crossref]  [PubMed]  [PMC] 
  6. Krathen RA, Orengo IF, Rosen T. Cutaneous metastasis: a meta-analysis of data. South Med J. 2003;96(2):164-167. [Crossref]  [PubMed] 
  7. Sittart JA, Senise M. Cutaneous metastasis from internal carcinomas: a review of 45 years. An Bras Dermatol. 2013;88(4):541-544. [Crossref]  [PubMed]  [PMC] 
  8. Pitman KT, Johnson JT. Skin metastases from head and neck squamous cell carcinoma: incidence and impact. Head Neck. 1999;21(6):560-565. [Crossref]  [PubMed] 
  9. Yoskovitch A, Hier MP, Okrainec A, Black MJ, Rochon L. Skin metastases in squamous cell carcinoma of the head and neck. Otolaryngol Head Neck Surg. 2001;124(3):248-252. [Crossref]  [PubMed] 
  10. Ferlito A, Shaha AR, Silver CE, Rinaldo A, Mondin V. Incidence and sites of distant metastases from head and neck cancer. ORL J Otorhinolaryngol Relat Spec. 2001;63(4):202-207. [Crossref]  [PubMed] 
  11. Bottoni U, Innocenzi D, Mannooranparampil TJ, Richetta A, Del Giudice M, Calvieri S. Inflammatory cutaneous metastasis from laryngeal carcinoma. Eur J Dermatol. 2001;11(2):124-126. [PubMed] 
  12. Schulman JM, Pauli ML, Neuhaus IM, et al. The distribution of cutaneous metastases correlates with local immunologic milieu. J Am Acad Dermatol. 2016;74(3):470-476. [Crossref]  [PubMed]  [PMC] 
  13. Zhao LP, Hu JH, Hu D, et al. Hyperprogression, a challenge of PD-1/PD-L1 inhibitors treatments: potential mechanisms and coping strategies. Biomed Pharmacother. 2022;150:112949. Erratum in: Biomed Pharmacother. 2023;164:114944. [Crossref]  [PubMed] 
  14. Habermehl G, Ko J. Cutaneous metastases: a review and diagnostic approach to tumors of unknown origin. Arch Pathol Lab Med. 2019;143(8):943-957. [Crossref]  [PubMed] 
  15. Strickley JD, Jenson AB, Jung JY. Cutaneous metastasis. Hematol Oncol Clin North Am. 2019;33(1):173-197. [Crossref]  [PubMed]