Transient Effectiveness of an Oral 5-Fluorouracil Derivative, S-1, for Epirubicin, Cyclophosphamide and Paclitaxel Refractory Skin Metastases from Possible Occult Breast Cancer in a Male

Abstract

Recent chemotherapies for skin metastases from breast cancer have shown to be effective for regression, disappearance, and favorable quality of life. We describe the case of a 76-year-old male showing transient effectiveness with an oral 5-fluorouracil derivative, S-1 (tegafur, 5-chloro-2,4-dihydroxypyridine and potassium oxonate), for epirubicin, cyclophosphamide and paclitaxel refractory skin metastases from possible occult breast cancer. The male patient was initially diagnosed as having lymph node metastases in the left axilla as possible occult breast cancer. The skin metastases developed after chemotherapy with a combination of epirubicin and cyclophosphamide, subsequent chemotherapy with paclitaxel, and radiotherapy. Chemotherapy with paclitaxel was resumed for skin metastases, but it was not effective. Alternative chemotherapy with the oral agent S-1 was administered. The skin metastases completely disappeared after the second course, but recurred at the end of the third course. This case suggests that S-1 may be a candidate for chemotherapy for skin metastases from occult breast cancer in males.

A case of HER2‐positive male occult breast carcinoma with skin and lymph node metastases that exhibited complete response to trastuzumab monotherapy

“…Male occult breast cancer is extremely rare, and only a few reports are available . Based on the initial diagnosis of occult lung cancer, and the National Comprehensive Cancer Network guidelines for occult primary carcinoma , we evaluated the present patient using a skin biopsy and immunohistochemical testing for cytokeratin 7, cytokeratin 20, GCDFP, ER, PR, and HER2.…”

“…There are only a few reports of male occult breast cancer (MOBC) [1][2][3][4][5][6], and only two cases were positive for HER2 [2,6]. One patient received trastuzumab-containing chemotherapy in the neoadjuvant setting [6], although this did not provide a favorable outcome.…”

Anticancer Therapy for Breast Cancer Patients with Skin Metastases Refractory to Conventional Treatments

“…This could be explained by the high penetration capacity of capecitabine and its metabolites to malignant and healthy tissue (Mader et al, 2003). In two patients who received capecitabine showed a dramatic response with resolution of their skin lesions (Sideras, 2008 agent S-1 showed its efficacy for the skin metastases developed or progressed after major chemotherapy combinations (Tokugawa, 2009;Hirao et al, 2011). So, current data potentially encourage documentation of cutaneous specific responses from fluorouracil (5-FU) derivatives in breast cancer patients with multiple skin metastases.…”