Long-Term Remission of an Aggressive Sebaceous Carcinoma following Chemotherapy

Abstract

Sebaceous carcinoma (SC) is an uncommon neoplasm manifesting itself either in the eyelid or extraocularly in the head and neck area. Surgery is the standard of care. Irradiation is rarely proposed as monotherapy but is frequently administered as an adjuvant regimen following surgical resection. There is no known strategy concerning chemotherapeutic treatment in highly aggressive recurrent - or metastatic - forms of the disease. Our patient presented with an aggressive SC of the scalp recurring after multiple excisions and local radiotherapy. Chemotherapy with 5-fluorouracil, cisplatin and docetaxel was then initiated; 4 cycles were administered, followed by capecitabine maintenance. Shortly after starting chemotherapy, dermal lesions had completely disappeared and radiological response could be seen. The patient experienced an extended period (>20 months) of complete remission. In this report, we show an excellent response of a highly aggressive SC after a combination of chemotherapy as for head and neck cancers.

Management Considerations in Extraocular Sebaceous Carcinoma

“…However, there are isolated reports of using imaging to stage extraocular SC with magnetic resonance imaging (MRI) 36,37 and positron emission tomography scan (PET). 38 Some have recommended the use of CT scan 6 PET as an imaging modality for patients with palpable regional lymphadenopathy, nodal metastasis on SLNB, or primary lesions, demonstrating aggressive features clinically or histologically.…”

A Case Report of Recurrent Metastatic Sebaceous Carcinoma Which Showed Favorable Response Tt Non-Fluorouracil Based Chemotherapy

“…Encouraged by these result, some studies suggested the possible role of systemic chemotherapy as neoadjuvant or adjuvant chemotherapy and illustrated positive result based on a few case reports [ 3 , 4 ]. However, most previously published reports were confined to only a few chemotherapeutic agents, especially 5-FU and platinum agents because these agents have been preferred in non-melanoma skin cancer and head and neck cancers [ 3 – 9 ]. However, when this regimen confronts resistance, patients ultimately require other systemic treatment option in the late of disease course.…”

“…First, we could confirm favorable response of capecitabine even after progression to 5-FU containing chemotherapy. To the best of our knowledge, only a few case reports have shown good responses to capecitabine or other fluorouracil agents (S-1) except 5-FU in sebaceous carcinoma [ 9 – 11 ]. Furthermore, in previous studies, capecitabine has been used in 5-FU naïve patients [ 10 ] and patients maintaining response to 5-FU [ 9 ].…”

“…To the best of our knowledge, only a few case reports have shown good responses to capecitabine or other fluorouracil agents (S-1) except 5-FU in sebaceous carcinoma [ 9 – 11 ]. Furthermore, in previous studies, capecitabine has been used in 5-FU naïve patients [ 10 ] and patients maintaining response to 5-FU [ 9 ]. Our case showed that capecitabine could be effective even after disease progression after 5-FU chemotherapy.…”

Expression of Anti-apoptotic Protein BAG3 in Human Sebaceous Gland Carcinoma of the Eyelid

“…Chemotherapy has been used for metastatic sebaceous gland carcinoma, but it is not effective (17,18). Accordingly, the study of sebaceous gland carcinoma-specific biomarkers is important for improving prognosis and treatment outcomes.…”