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Case report
Metastatic porocarcinoma achieving complete radiological and clinical response with pembrolizumab
  1. Karla A Lee1,2,
  2. Margherita Cioni3,
  3. Alistair Robson4,5 and
  4. Veronique Bataille6,7
  1. 1 Department of Twin Research, King’s College London, London, UK
  2. 2 The Royal Marsden NHS Foundation Trust, London, UK
  3. 3 Department of Dermatology, San Martino Policlinic Hospital, Genoa, Italy
  4. 4 LD Path Group, London, UK
  5. 5 Department of Pathology, Instituto Portugues de Oncologia de Lisboa Francisco Gentil EPE, Lisboa, Portugal
  6. 6 Kings College, London, UK
  7. 7 Dermatology, West Herts NHS Trust, Hemel Hempstead, UK
  1. Correspondence to Dr Karla A Lee, karla.lee{at}nhs.net

Abstract

A 67-year-old woman presented in 2012 with a crusty nodule on the left lower limb. Histopathological examination at this time reported a poorly differentiated squamous cell carcinoma (SCC). Two years later, she underwent lymphadenectomy and radiotherapy due to unilateral inguinal and pelvic sidewall nodal metastases. The following year she required excision of two subcutaneous lesions, reported pathologically to be SCC metastases. Further imaging following cyberknife radiotherapy to new brain metastases demonstrated widespread metastatic visceral disease. Twelve cycles of carboplatin and capecitabine failed to halt disease progression. In February 2017, she commenced pembrolizumab, achieving an excellent response and currently has no clinical or radiological evidence of disease. Given the unusual behaviour of her cancer, a histopathological review was requested. The diagnosis was revised to that of porocarcinoma (PC). This represents the first documented case of PC treated with immunotherapy. As of March 2019, the patient remains free of disease.

  • dermatology
  • skin cancer
  • therapeutic indications

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Footnotes

  • Contributors KAL prepared the manuscript and edited all drafts. MC contributed to the manuscript. VB was the treating dermatologist and contributed to the manuscript. AR reviewed the histopathology and contributed to the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Patient consent for publication Obtained.

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