The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University/Hunan Cancer Hospital, Changsha, China.
Department of Oncology, Turpan City People's Hospital, Tulufan, China.
Front Immunol. 2024 May 28;15:1337400. doi: 10.3389/fimmu.2024.1337400. eCollection 2024.
A 55-year-old male patient developed a mass in the left inguinal area with left lower limb swelling and first visited a local hospital 3 months earlier because of unrelieved pain. An MRI scan suggested left suprapubic branch and left acetabular bone destruction, abnormal soft tissue signals within the iliopsoas muscle of the anterior edge of the left iliac bone, and enlarged lymph nodes in the left iliac fossa and left inguinal region. The patient subsequently underwent left pelvic lesion open biopsy and inguinal lymph node resection biopsy. According to pathological reports, the left inguinal mass was considered to be a malignant tumor of cutaneous accessory origin (pilomatrix carcinoma) with extensive vitreous changes. The suprapupubis branch mass was considered to be a bone metastatic pilomatrix carcinoma. Immunohistochemistry (IHC) revealed a PDL1 combined positive score (CPS) of 8. DNA next-generation sequencing (NGS) showed L65Rfs*53 mutation. The patient received three cycles of gemcitabine and nedaplatin. However, the lesion progressed.
Chemotherapy is not effective for treating pilomatrix carcinoma. PDL1 antibodies and CDK4/6 inhibitors might be treatment options for pilomatrix carcinoma.
一名 55 岁男性患者左腹股沟区出现肿块，伴有左下肢肿胀，3 个月前因疼痛未缓解首次就诊于当地医院。MRI 扫描提示左耻骨上支和左髋臼骨破坏，左髂骨前缘髂腰肌内异常软组织信号，左髂窝和左腹股沟区淋巴结肿大。随后患者行左骨盆病变开放性活检和腹股沟淋巴结切除活检。根据病理报告，左腹股沟肿块被认为是起源于皮肤附属物的恶性肿瘤（毛母质癌），广泛玻璃样变。耻骨上支肿块被认为是骨转移的毛母质癌。免疫组化（IHC）显示 PDL1 联合阳性评分（CPS）为 8。DNA 下一代测序（NGS）显示 L65Rfs*53 突变。患者接受了三个周期的吉西他滨和顺铂化疗。然而，病变进展。
化疗对治疗毛母质癌无效。PDL1 抗体和 CDK4/6 抑制剂可能是毛母质癌的治疗选择。
