Advanced Squamous Cell Carcinoma Developed on Chronic Hidradenitis Suppurativa, Successfully Treated with Cemiplimab: A Case Report

Ruggiero, Angelo; Lauro, Wanda; Miano, Chiara; Villani, Alessia; Fabbrocini, Gabriella; Marasca, Claudio

doi:10.1159/000525347

Cited by 5 publications

(6 citation statements)

References 16 publications

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“…In addition, the rates of both lymph node and distant metastases in cSCC are higher in HS patients than in the general population [ 17 , 69 ], leading to a significantly reduced survival rate [ 17 ]. These results were confirmed in case reports and reviews [ 16 , 48–52 , 67 , 68 ]. Furthermore, therapy involving further excision of the affected areas and immunotherapy or a combination of both resulted in better treatment outcomes [ 16 , 48–52 , 67 , 68 ].…”

Section: Discussionsupporting

confidence: 72%

“…These results were confirmed in case reports and reviews [ 16 , 48–52 , 67 , 68 ]. Furthermore, therapy involving further excision of the affected areas and immunotherapy or a combination of both resulted in better treatment outcomes [ 16 , 48–52 , 67 , 68 ]. In contrast, treatment with Mohs micrographic surgery was associated with an increased mortality rate [ 16 , 28 , 48–52 , 67 , 68 ].…”

Section: Discussionsupporting

confidence: 72%

“…It is notable that even though HS is more common in women than in men, all but one study reported a higher incidence of cSCC in men [ 4 , 24 , 47 ]. Several studies have shown a higher incidence of cSCC in the buttock, gluteal, and anogenital regions affected by HS [ 16 , 28 , 29 , 48–52 , 67 , 68 ]. No cases have been reported in the axillary region to date.…”

Section: Discussionmentioning

confidence: 99%

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A state-of-the-art systematic review of cancer in hidradenitis suppurativa

Abu Rached,

Rüth,

Gambichler

et al. 2024

Annals of Medicine

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Purpose Hidradenitis suppurativa (HS) is a chronic inflammatory disease associated with an increased risk of malignancy. The aim of this systematic review was to investigate the prevalence of different malignancies in HS. Methods This review meets the PRISMA criteria. A data-driven approach was used to conduct the research, which involved a detailed keyword search. The study considered meta-analyses, experimental studies, case-control studies, cross-sectional studies, cohort studies, and recently published cases, published in English or German. Excluded were reviews, summaries, and letters to the editor, as well as studies, which are not based on the human population. Results Out of the initial 443 publications found, 25 met the inclusion criteria for this systematic review. Patients with HS have a significantly increased risk of cancer, up to 50%. Additionally, the risk of oropharyngeal, central nervous system, colorectal, prostate, vulvar and non-melanocytic skin cancers increase with the severity of HS. The likelihood of comorbid lymphoma in patients with HS is significantly higher compared to healthy controls. In severe cases of HS, malignant degeneration of lesions in the groin, perianal, perineal, and gluteal region can occur in up to 4.6% of cases. This leads to the development of cSCC, which often have a complicated course, are more refractory to treatment and associated with a poorer outcome. The pathogenic mechanisms responsible for the malignant transformation of HS are currently unknown. Conclusions Patients with HS have a higher risk of cancer compared to the general population. Untreated, long-standing HS lesions can lead to complicated malignant degeneration resulting in cutaneous squamous cell carcinoma. The mechanisms underlying this malignant degeneration are not fully understood. HS patients also have an increased risk of developing other cancers, including prostate, oral, pharyngeal and colorectal cancers of the central nervous system and lymphomas.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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A state-of-the-art systematic review of cancer in hidradenitis suppurativa

Abu Rached,

Rüth,

Gambichler

et al. 2024

Annals of Medicine

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“…The majority of cSCC cases were treated successfully with standard wide local excision and/or radiotherapy, However, 5% of cSCC were considered unrespectable either locally advanced or metastatic disease, which have a dismal outcome. Fortunately, novel immunotherapy that target the PD-1 pathway is causing a paradigm shift in cSCC with better tolerability and fewer side effects than traditional modalities [ 9–11 ], which recently considered as a suitable treatment to reduce the morbidity and mortality of cSCC developing in HS [ 12 , 13 ]. In our case, Anti PD-1 therapy was started as a first-line treatment due to the ineligibility of the patient to surgery.…”

Section: Discussionmentioning

confidence: 99%

A late presentation of inguinoscrotal cutaneous squamous cell carcinoma (cSCC) masquerading as hidradenitis suppurativa—a case report

Lahham,

Billan,

Atrash

et al. 2023

Journal of Surgical Case Reports

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that affects apocrine gland-bearing skin in intertriginous areas; it is characterized by persistent or recurrent abscesses that culminate in a purulent discharge, sinuses and scarring. Although it is a common condition, it is rarely associated with cutaneous squamous cell carcinoma (cSCC). Whereas the female-to-male ratio of HS is 3:1, SCC in HS has a female-to-male ratio of 1:5. In this study, we present a 50-year-old male patient with a late presentation of inguinoscrotal cSCC with extensive ulceration and erythema that was hidden by neglected HS and the presence of underlying human papillomavirus in the affected area. The histomorphologic and immunohistochemical findings support the diagnosis of cSCC. Timely detection is the key to improve prognosis, regular clinical examination and biopsy of any suspicious lesions in high-risk patients is highly recommended.

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“…Extensive information on systemic treatment is also not available, with a total of 12 patients having received such treatment in different modalities (12.7%). A recent case report has highlighted successful treatment with cemiplimab ( 70 ), showing that anti-PD-1 drugs are a credible treatment option for cSCC, regardless of origin.…”

Section: Hidradenitis Suppurativamentioning

confidence: 99%

Treatment of metastatic squamous cell carcinoma arising in sacrococcygeal pilonidal sinus: a case report series

Soria Rivas,

Bea-Ardebol,

Vida Navas

et al. 2023

Front. Med.

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BackgroundSquamous cell carcinoma (SCC) arising in a sacrococcygeal pilonidal sinus is rare, with cases of metastatic disease being even rarer. Among published cases, almost none have reported on systemic treatment.ObjectiveThis disease has a poorer prognosis than other forms of cutaneous SCC; therefore, our objective is to shed some light on the treatment of metastatic disease.MethodsWe present a series of nine cases treated at a single center, four of whom received systemic treatment. Additionally, other previously reported cases of metastatic disease are included in an attempt to draw stronger conclusions.ResultsFour patients were treated under several treatment regimens, with a median progression-free survival of only 2 months and two instances of partial response (18%). The best result was achieved with cemiplimab. Across all the cases, there was a trend toward a benefit of the use of systemic treatment (HR 0.41, 95% CI 0.15–1.12, p = 0.083; median overall survival 13 vs. 8 months).LimitationsLimitations include the significant lack of information on previously published cases and the extremely heterogeneous nature of the existing information.ConclusionThe initial systemic treatment should be an anti-PD-1, as with other SCCs. After progression on anti-PD-1, there is no strong evidence to support the recommendation of a specific treatment or sequence: options include cetuximab and/or chemotherapy (platinum, paclitaxel, 5-fluorouracyl).

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Advanced Squamous Cell Carcinoma Developed on Chronic Hidradenitis Suppurativa, Successfully Treated with Cemiplimab: A Case Report

Cited by 5 publications

References 16 publications

A state-of-the-art systematic review of cancer in hidradenitis suppurativa

A state-of-the-art systematic review of cancer in hidradenitis suppurativa

A late presentation of inguinoscrotal cutaneous squamous cell carcinoma (cSCC) masquerading as hidradenitis suppurativa—a case report

Treatment of metastatic squamous cell carcinoma arising in sacrococcygeal pilonidal sinus: a case report series

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