1 Department of Internal Medicine, 2 Department of Dermatology, 3 Department of Pathology, Chung Shan Medical University Hospital and School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan, China.
Chin J Cancer Res. 2014 Feb;26(1):E5-9. doi: 10.3978/j.issn.1000-9604.2014.01.02.
Cutaneous metastases are rare and seldom present at the time of first diagnosis of cancer. Data from various studies show that 1-12% of lung cancer patients experience tumor spread to the skin. The scalp, chest, and abdomen are favored sites of skin metastases from lung cancers, but metastases to multiple skin sites in a single patient are rarely reported. We describe a 56-year-old lung adenocarcinoma patient, initially diagnosed with steatocystoma multiplex who responded well to gefitinib treatment. The efficacy of conventional chemotherapy for cutaneous metastases has been limited because of the relatively poor blood supply to the skin. It has been demonstrated that tyrosine kinase inhibitor (TKI), gefitinib, has significant clinical benefit in lung cancer patients with epidermal growth factor receptor (EGFR) mutation even in metastases to the brain. However, the therapeutic response to gefitinib in patients with skin metastases is seldom mentioned in the literature. We report one case of lung adenocarcinoma with multiple skin metastases that were successfully treated with gefitinib.
皮肤转移较为罕见,且通常在首次诊断癌症时不会出现。来自多项研究的数据表明,1-12%的肺癌患者会发生肿瘤扩散至皮肤。肺癌皮肤转移的好发部位为头皮、胸部和腹部,但同一患者多个皮肤部位发生转移的情况较为少见。我们描述了一例 56 岁肺腺癌患者,最初诊断为多发性皮脂囊瘤,对吉非替尼治疗反应良好。由于皮肤的相对血供较差,常规化疗对皮肤转移的疗效有限。已证实,表皮生长因子受体 (EGFR) 突变的肺癌患者使用酪氨酸激酶抑制剂 (TKI) 吉非替尼治疗具有显著的临床获益,甚至对脑转移也有效。然而,文献中很少提到吉非替尼治疗皮肤转移患者的治疗反应。我们报告了一例肺腺癌伴多发皮肤转移的病例,该患者使用吉非替尼治疗获得成功。