Androgen-Receptor Positive Lacrimal Sac Adenocarcinoma Demonstrating Long-Lasting Response to LHRH Analog Plus Abiraterone Treatment

Abstract

Tumors arising at the lacrimal sac are extremely rare, as a limited number of cases have been reported worldwide. They are commonly primary and the majority of them are malignant and epithelial in origin. Adenocarcinomas account for a small percentage of these tumors. Treatment of local disease mainly includes complete surgical resection. However, metastatic disease has a poor prognosis and the development of new treatment strategies is highly important. Research efforts mainly focus on the identification of molecular targets for therapy. Herein, we describe for the first time a case of a patient with an androgen receptor expressing adenocarcinoma of the lacrimal sac that had an impressive response to abiraterone.

Androgen receptor-positive ductal adenocarcinoma of the nasolacrimal duct: A case report

“… 26 One previously described patient with AR-positive lacrimal sac adenocarcinoma showed an impressive response to antiandrogen treatment (abiraterone). 16 Our present patient was treated with a wide surgical resection followed by radiation therapy, and has survived for 16 months after surgery with no evidence of local recurrence or distant metastasis.…”

“…Since Katz et al. reported the first case of ductal adenocarcinoma of the lacrimal gland in 1996 4 , only 16 further cases involvingthe lacrimal gland 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 and two involving the lacrimal sac 16 , 17 have been described ( Table 1 ). IHC for AR was performed in seven lacrimal gland and two lacrimal sac tumors, all of which showed positive results (100%).…”

“…IHC for AR was performed in seven lacrimal gland and two lacrimal sac tumors, all of which showed positive results (100%). 8 , 14 , 15 , 16 IHC for HER-2/neu was performed in eight cases, of which four were positive (50%). 8 , 10 , 11 , 15 The first case of primary ductal adenocarcinoma of the lacrimal sac was reported in 2013 and showed diffuse positivity for AR but was negative for HER-2/neu on IHC.…”

“…17 (2013) 79 Female Lacrimal sac + N/A N/A N/A Min et al. 12 (2014) 46 Male Lacrimal gland N/A N/A N/A N/A Vagia 16 et al. (2015) 65 Male Lacrimal sac + N/A N/A + Zhu et al.…”

Proteinase 3; a potential target in chronic obstructive pulmonary disease and other chronic inflammatory diseases

“…Despite the potential to impede bacterial clearance, it has also been reported that PR3 itself possesses bactericidal properties through cleavage of the pro-microbicidal protein hCAP-18 (human cathelicidin) into the antibacterial peptide, mucus inducer and neutrophil chemo-attractant LL-37 [ 51 , 75 – 78 ]. Furthermore, levels of LL-37 in sputum are related to disease severity in patients with COPD suggesting an indirect role for PR3 which is worthy of further investigation [ 79 ].…”