Matsumoto Masataka, Kaneshiro Kazumi, Takatsuki Kiyonobu
Department of Respiratory Medicine, Kitaharima Medical Center, Ichiba-cho, Ono, Hyogo, 675-1392, Japan.
J Med Case Rep. 2021 Mar 30;15(1):160. doi: 10.1186/s13256-021-02754-0.
Xeroderma pigmentosum is a rare, autosomal-recessive photosensitive dermatosis. Patients with xeroderma pigmentosum have an impaired ability to repair deoxyribonucleic acid damage caused by ultraviolet rays, resulting in skin cancer. Patients with xeroderma pigmentosum are more susceptible to some cancers. We herein report a case of xeroderma pigmentosum accompanied by lung cancer.
The patient was a Japanese woman in her 70s with a family history of consanguineous marriage. Her medical history included squamous cell carcinoma and basal cell carcinoma, in addition to xeroderma pigmentosum. She presented with dry skin with small, pigmented spots, which were particularly focused around the areas exposed to sunlight. Chest computed tomography was conducted to assess for any evidence of metastatic skin carcinoma, and revealed a tumor in the left upper subpleural lobe of the lung. Consequently, she was referred to our department. Finally, we diagnosed lung adenocarcinoma (pT2aN0M1b: stage IVA). She had an epidermal growth factor receptor (EGFR) mutation (p.L858R). Treatment with an epidermal growth factor receptor tyrosine kinase inhibitor (gefitinib) was initiated, and the tumor gradually regressed. No side effects were observed. However, she later died from aspiration pneumonia.
Although xeroderma pigmentosum is rare, a history of consanguineous marriage should be verified. Because of the severe side effects of cisplatin and radiotherapy in xeroderma pigmentosum patients, the risks and benefits of treatment should be considered thoroughly.
着色性干皮病是一种罕见的常染色体隐性遗传性光敏性皮肤病。着色性干皮病患者修复由紫外线引起的脱氧核糖核酸损伤的能力受损,从而导致皮肤癌。着色性干皮病患者更容易患某些癌症。我们在此报告一例伴有肺癌的着色性干皮病病例。
患者为一名70多岁的日本女性,有近亲结婚家族史。她的病史包括鳞状细胞癌、基底细胞癌以及着色性干皮病。她表现为皮肤干燥,有小的色素沉着斑点,尤其集中在暴露于阳光的部位。进行胸部计算机断层扫描以评估是否有转移性皮肤癌的证据,结果显示左肺上叶胸膜下有一个肿瘤。因此,她被转诊至我们科室。最终,我们诊断为肺腺癌(pT2aN0M1b:IVA期)。她存在表皮生长因子受体(EGFR)突变(p.L858R)。开始使用表皮生长因子受体酪氨酸激酶抑制剂(吉非替尼)进行治疗,肿瘤逐渐缩小。未观察到副作用。然而,她后来死于吸入性肺炎。
尽管着色性干皮病罕见,但应核实近亲结婚史。由于顺铂和放疗对着色性干皮病患者有严重的副作用,应充分考虑治疗的风险和益处。