Saintes C, Saint-Jean M, Brocard A, Peuvrel L, Renaut J J, Khammari A, Quéreux G, Dréno B
Skin Cancer Unit, CHU Hôtel Dieu, Nantes, France.
J Eur Acad Dermatol Venereol. 2015 May;29(5):1006-9. doi: 10.1111/jdv.12526. Epub 2014 Jul 1.
Basal cell carcinoma (BCC) is the most common cancer in humans. Vismodegib, a Hedgehog pathway inhibitor, has proved its effectiveness in treating non-resectable advanced BCC.
However, its action on squamous cell carcinoma (SCC) is unknown. We present three SCC cases developed into BCC in vismodegib-treated patients.
We have described three cases of patients developing SCC during treatment by vismodegib for BCC.
Patient 1 was treated with vismodegib for five facial BCC. Due to the progression of one of the lesions at month 3 (M3), a biopsy was performed and showed SCC. Patient 2 was treated with vismodegib for a large facial BCC. A biopsy was performed at M2 on a BCC area not responding to treatment and showed SCC. Patient 3 was treated with vismodegib for a BCC on the nose. Due to vismodegib ineffectiveness, a biopsy was performed and showed SCC.
Two similar cases have been described in the literature. This could be due to the appearance of the squamous contingent of a metatypical BCC or to the squamous differentiation of stem cells through inhibition of the hedgehog pathway.
In practice, any dissociated response of a BCC to vismodegib should be biopsied.
基底细胞癌（BCC）是人类最常见的癌症。维莫德吉，一种刺猬信号通路抑制剂，已证明其在治疗不可切除的晚期BCC方面的有效性。
然而，其对鳞状细胞癌（SCC）的作用尚不清楚。我们报告了3例在接受维莫德吉治疗的患者中发展为BCC的SCC病例。
我们描述了3例在接受维莫德吉治疗BCC期间发生SCC的患者病例。
患者1因面部5处BCC接受维莫德吉治疗。由于其中一个病灶在第3个月（M3）进展，进行了活检，结果显示为SCC。患者2因面部一处大型BCC接受维莫德吉治疗。在第2个月（M2）对一处对治疗无反应的BCC区域进行了活检，结果显示为SCC。患者3因鼻部BCC接受维莫德吉治疗。由于维莫德吉治疗无效，进行了活检，结果显示为SCC。
文献中已描述了2例类似病例。这可能是由于化生型BCC的鳞状成分出现，或由于刺猬信号通路受抑制导致干细胞发生鳞状分化。
在实际操作中，BCC对维莫德吉出现的任何分离反应均应进行活检。
