Carcinoma Basocelular com Metastização Óssea Disseminada: Um Desfecho Invulgar da Doença Maligna Mais Comum

  • Luísa Rolim Department of Radiation Oncology, Coimbra University Hospital, Coimbra, Portugal
  • Bruno M. Fernandes Department of Radiation Oncology, Coimbra University Hospital, Coimbra, Portugal
  • Carolina Carvalho Department of Radiation Oncology, Coimbra University Hospital, Coimbra, Portugal
  • António Silva 1Department of Radiation Oncology, Coimbra University Hospital, Coimbra, Portugal
  • Joana Calvão Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal https://orcid.org/0000-0002-1161-269X
  • Ricardo Vieira Department of Dermatology, Coimbra University Hospital, Coimbra, Portugal https://orcid.org/0000-0002-5914-9171
  • Margarida Borrego Department of Radiation Oncology, Coimbra University Hospital, Coimbra, Portugal
DOI: https://doi.org/10.29021/spdv.79.3.1335
Palavras-chave: Carcinoma Basocelular/secundário, Carcinoma Basocelular/tratamento farmacológico, Metástase Neoplásica/radioterapia, Neoplasias da Pele/tratamento farmacológico

Resumo

O carcinoma basocelular é o cancro de pele mais comum, com uma incidência muito baixa de metástases, associada a alta morbilidade e mortalidade. A variante clínica morfeiforme é incomum, apresentando um padrão de crescimento agressivo. O diagnóstico precoce e as novas terapias-alvo para a doença metastática são importantes para melhorar as taxas de sobrevivência. Apresentamos o caso de um doente de 29 anos, com carcinoma basocelular morfeiforme na região geniana direita. Devido a recorrências locais, foi submetido a cirurgia e a radioterapia adjuvante. Por extenso envolvimento ósseo metastático, o doente iniciou vismodegib e, mais tarde, pembrolizumab, tendo realizado radioterapia paliativa antiálgica. Apesar das várias linhas de terapêutica sistémica, a doença progrediu, e o doente faleceu após 8 anos de seguimento. Este caso mostra como é crucial identificar fatores de risco para o basalioma metastático, e destaca a necessidade de melhorar as terapias-alvo e de adaptá-las ao perfil biológico do doente.

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Referências

Freitas PP, Senna CG, Tabai M, Chone CT, Altemani A. Metastatic basal cell carcinoma: a rare manifestation of a common disease. Case Rep Med. 2017:1-4. doi: 10.1155/2017/8929745.

Nguyen-Nielsen M, Wang L, Pedersen L, Olesen AB, Mackey H, McCusker M, et al. The incidence of metastatic basal cell carcinoma (mBCC) in Denmark, 1997-2010. Eur J Dermatol. 2015;25:463-468.

Snow SN, Sahl W, Lo JS, Mohs FE, Warner T, Dekkinga JA, et al. Metastatic basal cell carcinoma. Report of five cases. Cancer. 1994;73:328-35.

von Domarus H, Stevens PJ. Metastatic basal cell carcinoma. Report of five cases and review of 170 cases in the literature. J Am Acad Dermatol. 1984;10:1043-60.

Wysong A, Aasi SZ, Tang JY. Update on metastatic basal cell carcinoma: A summary of published cases from 1981 through 2011. JAMA Dermatol. 2013;149:615-6.

Ascierto PA, Garbed C. Updates and new perspectives in nonmelanoma skin cancer from “Immunotherapy Bridge”. Immunotherapy. 2020;12:167-74. doi: 10.2217/imt-2020-0042.

Rodriguez C, Barriuso V, Chan LS. Extensive basal cell carcinoma with probable bone mestatases. Cutis. 2007;80:60-6.

McCusker M, Basset-Seguin N, Dummer R, Lewis K, Schadendorf D, Sekulic A, et al. Metastatic basal cell carcinoma: prognosis dependent on anatomic site and spread of disease. Eur J Cancer. 2014;50:774-83. doi: 10.1016/j.ejca.2013.12.013.

Spates ST, Mellette JR Jr, Fitzpatrick J. Metastatic basal cell carcinoma. Dermatol Surg. 2003;29:650-652.

Lau J, Guminski A, Gill A, Veivers D. Metastatic basal cell carcinoma: a review of six cases. Aust J of Otolaryngol. 2018;1:20.

Han A, Ratner D. What is the role of adjuvant radiotherapy in the treatment of cutaneous squamous cell carcinoma with perineural invasion? Cancer 2007;109:1053-1059.

National Comprehensive Cancer Network. Clinical Practice Guidelines in Oncology. Basal Cell Skin Cancer. Version 1.2021. Fort Washington: NCCN; 2021.

Sekulic A, Migden MR, Oro AE, Dirix L, Lewis K, Hainsworth JD, et al. Efficacy and safety of vismodegib in advanced basal-cell carcinoma. N Engl J Med. 2012;366:2171-9. doi: 10.1056/NEJMoa1113713.

Migden MR, Guminski A, Gutzmer R, Dirix L, Lewis KD, Combemale P, et al. Treatment with two different doses of sonidegib in patients with locally advanced or metastatic basal cell carcinoma (BOLT): a multicentre, randomised, double-blind phase 2 trial. Lancet Oncol. 2015;16:716-78. doi: 10.1016/S1470-2045(15)70100-2.

Basset-Seguin N, Hauschild A, Grob JJ, Kunstfeld R, Dréno B, Mortier L, et al. Vismodegib in patients with advanced basal cell carcinoma (STEVIE): a pre-planned interim analysis of an international, open-label trial. Lancet Oncol. 2015;16:729-36. doi: 10.1016/S1470-2045(15)70198-1.

Jacobsen AA, Aldahan AS, Hughes OB, Shah VV, Strasswimmer J. Hedgehog pathway inhibitor therapy for locally advanced and metastatic basal cell carcinoma: a systematic review and pooled analysis of interventional studies. JAMA Dermatol. 2016;152:8. doi: 10.1001/jamadermatol.2016.0780.

Sekulic A, Migden MR, Basset-Seguin N, Garbed C, Gesierich A, Lao CD, et al. Long-term safety and efficacy of vismodegib in patients with advanced basal cell carcinoma: Final update of the pivotal ERIVANCE BCC study. BMC Cancer. 2017;17:332. doi: 10.1186/s12885-017-3286-5.

Cannon JGD, Russell JS, Kim J, Chang ALS. A case of metastatic basal cell carcinoma treated with continuous PD-1 inhibitor exposure even after subsequent initiation of radiotherapy and surgery. JAAD Case Rep. 2018;4:248-250.

Noubissi FK, Yedjou CG, Spiegelman VS, Tchounwou PB. Cross-Talk between Wnt and Hh Signaling Pathways in the Pathology of Basal Cell Carcinoma. Int J Environ Res Public Health. 2018;15:1442. doi: 10.3390/ijerph15071442.

Chang J, Zhu GA, Cheung C, Li S, Kim J, Chang AL. Association between programmed death ligand 1 expression in patients with basal cell carcinomas and the number of treatment modalities. JAMA Dermatol. 2017;153:285-90. doi: 10.1001/jamadermatol.2016.5062.

Moeholt K, Aagaard H, Pfeiffer P, Hansen O. Platinum-based cytotoxic therapy in basal cell carcinoma-a review of the literature. Acta Oncol. 1996;35:677-82.

Kim DJ, Kim J, Spaunhurst K, Montoya J, Khodosh R, Chandra K, et al. Open-label, exploratory phase II trial of oral itraconazole for the treatment of basal cell carcinoma. J Clin Oncol. 2014;32:745-51. doi: 10.1200/JCO.2013.49.9525.

Publicado
2021-10-17
Como Citar
Rolim, L., M. Fernandes, B., Carvalho, C., Silva, A., Calvão, J., Vieira, R., & Borrego, M. (2021). Carcinoma Basocelular com Metastização Óssea Disseminada: Um Desfecho Invulgar da Doença Maligna Mais Comum. Revista Da Sociedade Portuguesa De Dermatologia E Venereologia, 79(3), 261-264. https://doi.org/10.29021/spdv.79.3.1335
Edição
v. 79 n. 3 (2021): Julho - Setembro
Secção
Casos Clínicos

Direitos de Autor (c) 2021 Revista da Sociedade Portuguesa de Dermatologia e Venereologia

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