Disclosures:The authors indicated no financial relationships.
Dear Editor,We read the article by Cannon et al. [1] with great interest. The authors reported five ovarian and fallopian tubal cancer patients who developed oromaxillary squamous cell carcinoma (SCC) during long-term maintenance therapy with pegylated liposomal doxorubicin (PLD) (range, 30 -132 months; cumulative dose, 1,696 -3,000 mg/m 2 ). Notably, four of the five patients were positive for a BRCA mutation, suggesting a hereditary component to long-term PLD use and subsequent susceptibility to oromaxillary cancer in ovarian cancer patients.Recently, a case of primary buccal SCC arising in a patient with uterine papillary serous carcinoma after longterm PLD treatment was seen in our institution. Briefly, a 56-year-old Hispanic woman without a family history of cancer or personal history of smoking was diagnosed with stage IV uterine papillary serous carcinoma. She received neoadjuvant chemotherapy with carboplatin and paclitaxel (three cycles) followed by interval tumor reduction. Postoperatively, she was given four additional cycles of carboplatin and paclitaxel, followed by whole pelvic radiotherapy (5,040 cGy) with weekly cisplatin. She developed vaginal cuff and retroperitoneal nodal recurrence 4 months after the completion of radiotherapy, and PLD treatment was therefore initiated. Brain metastases were detected 23 months after the initial surgical staging. The tumor was resected via craniotomy and she received whole brain radiotherapy thereafter (3,000 cGy). She continued to receive PLD (47 cycles total), with a cumulative dose of 3,924 mg until she progressed. The entire duration of PLD treatment was tolerated well without remarkable adverse events (intermittent