Rapid onset of cutaneous squamous cell carcinoma of the penis in a patient with psoriasis on etanercept therapy

Malignant Carcinoid Tumor of the Rectum in a Patient With Psoriatic Arthritis Treated With Etanercept

“…They include a patient who developed non-Hodgkin's lymphoma (NHL) after etanercept treatment for ankylosing spondylitis [16], a patient with rapid onset development of a rare human papilloma virus-negative squamous cell carcinoma of the penis shortly after starting etanercept therapy for psoriasis [17], a patient who developed oropharyngeal carcinoma after combination of methotrexate and etanercept for RA [18] and a series of seven patients who developed one or more squamous cell carcinoma after starting etanercept treatment for RA [19]. Also, although infrequent, solid tumor cases have been specifically reported in PsA patients treated with etanercept such as a primary thyroid marginal zone B-cell lymphoma [20] and a rare variant of squamous cell carcinoma called carcinoma cuniculatum [21].…”

“…As presented above, there have been several case reports of cutaneous solid malignancies developing after treatment with etanercept Adrianzen Herrera et al J Med Cases. 2015;6(9):389-392 and in some of them the short time spam between initiation of the drug and the development of the tumor was used as indirect prove of association [17,18]; other cases, however, do not follow this timeline pattern and long periods of time have been reported between initiation of etanercept and the development of the tumor, particularly in PsA [19]. Furthermore, the rapid onset may point to subclinical tumors already present at the time of initiating therapy that manifest clinically after the suppressed immunity conferred by the agent [19].…”

Development of Two Primary Malignant Melanomas after Treatment with Adalimumab: A Case Report and Review of the Possible Link between Biological Therapy with TNF-α Antagonists and Melanocytic Proliferation

“…A large-scale cohort study [11] in patients with RA concluded that there was an increased risk of non-melanoma skin cancer in those receiving TNF-α antagonists, when prescribed either alone (hazard ratio, 1.24) or in combination with methotrexate (hazard ratio, 1.97). There are a few recent case reports that underline the possible link between TNF-α antagonists and the induction or rapid reactivation of latent malignancies [12]. Furthermore, the reactivation of melanoma in immunosuppressed patients after solid organ transplantation is well established [13].…”

Rapid Onset and Fatal Outcome of Two Squamous Cell Carcinomas of the Genitalia in a Patient Treated with Etanercept for Cutaneous Psoriasis

“…However, the more recent use of these therapeutics in psoriasis patients raises this question in more critical terms due to the previous use in this subset of patients of immunosuppressive or potentially carcinogenic therapies such as phototherapy, methotrexate, ciclosporine or coaltar, as illustrated by the rapid onset of penile cutaneous squamous cell carcinoma (SCC) in a patient receiving etanercept for psoriasis [4] . We hereby report on a similar observation emphasizing this potential risk.…”

“…In this perspective, the report of 7 cutaneous SCCs of rapid onset in 5 rheumatoid arthritis patients receiving etanercept for a limited period of time was initially worrisome regarding a higher risk of cutaneous tumors, but no additional case was reported since then with the noticeable exception of a penile SCC in a patient receiving etanercept for psoriasis [4] . However, previous exposure to high doses of UVA or UVB and/or to other immunosuppressive agents such as ciclosporine for psoriasis probably delineates a special subset of patients at higher risk of developing SCC when compared to other indications such as rheumatoid arthritis, the genital area being perhaps the more significant target as already reported in psoriasis [5] and as illustrated both by our observation and by the report of Fryrear et al [4] . The hypothesis of a previous but latent infection by oncogenic strains of HPV can be raised as well since the onset of genital HPV lesions occurring in patients receiving anti-TNF-␣ agents has recently been reported [6] ; however, no clue for the presence of HPV sequences was present in our patient.…”