Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 16, 2022; 10(14): 4586-4593
Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4586
Primary or metastatic lung cancer? Sebaceous carcinoma of the thigh: A case report
Xiao-Lin Wei, Qing Liu, Qiang-Lin Zeng, Hui Zhou
Xiao-Lin Wei, Department of Respirology, Taikang Sichuan Southwest Hospital Company Limited, Chengdu 610095, Sichuan Province, China
Qing Liu, Department of Abdominal Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu 610000, Sichuan Province, China
Qiang-Lin Zeng, Hui Zhou, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University School of Clinical Medicine, Chengdu University, Chengdu 610081, Sichuan Province, China
Author contributions: Wei XL and Zhou H designed and drafted the work; Liu Q and Zeng QL revised it, all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hui Zhou, MD, Professor, Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Chengdu University School of Clinical Medicine, Chengdu University, No. 82 North Section 2, 2nd Ring Road, Chengdu 610081, Sichuan Province, China. zhouhuicdu@hotmail.com
Received: October 12, 2021
Peer-review started: October 12, 2021
First decision: December 10, 2021
Revised: December 23, 2021
Accepted: March 25, 2022
Article in press: March 25, 2022
Published online: May 16, 2022
Processing time: 213 Days and 5.5 Hours
Abstract
BACKGROUND

Sebaceous carcinoma (SC), a malignancy primarily characterized by aggressive growth, affects cutaneous tissues of the periocular region. Extraocular SC is extremely rare, especially in the extremities, as evidenced by only a handful of reported cases.

CASE SUMMARY

A 65-year-old man presented with a rapidly enlarging swelling on the left inner thigh, which was initially misdiagnosed as a subcutaneous abscess. The lesion had appeared two months prior to admission. Clinical examination revealed a cauliflower-like swollen content, with an ulcerated and infected mass located on his left thigh. At the same time, we observed solitary nodular lesions in his lungs and brain, with biopsy pathology of the lung lesions found to be consistent with the mass in the thigh. The patient received chemotherapy comprising cis-platinum with fluorouracil, followed by targeted therapy with anlotinib hydrochloride and chemotherapy with vinorelbine, implantation of iodine-125 seeds in the thigh and pulmonary tumor. The initial stage intervention achieved partial remission. The efficacy of maintenance treatment was evaluated as stable disease after the first 5 cycles; however, the patient developed a new brain lesion after the sixth cycle of treatment, which resulted in progressive disease and he received whole brain gamma knife radiotherapy.

CONCLUSION

We analyzed the clinical presentation, imaging features, pathology and treatment of a rare case of lung, brain and lymph node metastasis of SC located in the thigh. It is evident that cis-platinum combined with fluorouracil, vinorelbine combined with anlotinib hydrochloride may be an effective therapeutic regimen in advanced SC. However, brain metastatic lesions should receive early radiotherapy.

Keywords: Extraocular sebaceous carcinoma; Chemotherapy; Targeted therapy; Radiotherapy; Case report

Core Tip: Sebaceous carcinoma (SC) is a rare malignant tumor of skin, mainly occurring in the head and neck, but rarely in the limbs. The diagnosis and treatment of SC remains unclear due to its rarity. Our patient presented with a skin mass with lung and brain lesions, which should be distinguished from skin metastasis of lung cancer. After comprehensive treatment, the patient achieved a good effect in the early stage, the later stage of the disease tended to be stable. It seems that cis-platinum combined with fluorouracil, vinorelbine combined with anlotinib hydrochloride may be an effective therapeutic regimen.