Metastatic Porocarcinoma Effectively Managed by Pembrolizumab - PubMed (original) (raw)

Case Reports

. 2021 Nov 29;13(11):e20004.

doi: 10.7759/cureus.20004. eCollection 2021 Nov.

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Case Reports

Metastatic Porocarcinoma Effectively Managed by Pembrolizumab

Arminder Singh et al. Cureus. 2021.

Abstract

Eccrine porocarcinoma (EPC) is a rare malignancy of the sweat glands. Currently, there is no standard algorithm for its presentations, diagnosis, and management. However, immunotherapy is an emerging option that may be crucial to the treatment of EPC. This report presents a case of a 79-year-old male who had a skin biopsy of an anterior scalp lesion, which revealed EPC. The patient underwent Mohs micrographic surgery to excise the tumor followed by two additional Mohs surgeries for recurrence and adjuvant radiotherapy. A follow-up positron emission tomography (PET) scan revealed yet another recurrence at the scalp as well as metastases to the left parotid gland and left submandibular lymph node. The patient was started on immunotherapy with pembrolizumab, a programmed cell death protein 1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitor, and later achieved remission. This report demonstrates the effective management of EPC using immunotherapy with pembrolizumab.

Keywords: eccrine porocarcinoma; immunotherapy; malignant eccrine poroma; malignant neoplasm of eccrine glands; pembrolizumab; porocarcinoma.

Copyright © 2021, Singh et al.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1

Figure 1. Patient 's anterior scalp during Mohs surgery

Figure 2

Figure 2. PET scan representing the first lesion near parotid gland (black arrow)

PET, positron emission tomography

Figure 3

Figure 3. PET scan representing the second lesion near parotid gland (black arrow)

PET, positron emission tomography

Figure 4

Figure 4. PET scan demonstrating resolution of lesion seen in Figure 2 after 9 months of immunotherapy with pembrolizumab

PET, positron emission tomography

Figure 5

Figure 5. PET scan demonstrating resolution of lesion seen in Figure 3 after 9 months of immunotherapy with pembrolizumab

PET, positron emission tomography

Figure 6

Figure 6. Patient’s anterior scalp after three Mohs micrographic surgeries with adjuvant radiotherapy and 11 months of receiving pembrolizumab

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