Cutaneous adnexal adenocarcinoma with exquisite sensitivity to trastuzumab

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Abstract

Background: Cutaneous adnexal adenocarcinoma is a rare cancer that is occasionally human epidermal growth factor receptor-2 (HER-2)-positive, and demonstrates variable response to HER-2 inhibitors. Methods: We report a case of adnexal adenocarcinoma of the scalp in a 56-year-old man. He underwent wide local excision with cervical node dissection followed by radiation, but had extensive local recurrence. Results: Pathology demonstrated a poorly differentiated adnexal adenocarcinoma with HER-2 overexpression by immunohistochemistry (IHC) and high HER-2 gene amplification by fluorescence in situ hybridization. The patient was treated with trastuzumab-based therapy with dramatic response and clinical resolution of the tumor. Upon pausing trastuzumab, he developed local relapse, but had an excellent response to restarting trastuzumab monotherapy. He lacks visible disease 43 months after the initial diagnosis. Conclusion: We believe the exquisite sensitivity of the primary carcinoma and subsequent recurrence to trastuzumab therapy was due to strong HER-2 expression both at the protein and gene level.

Original languageEnglish (US)
JournalHead and Neck
DOIs
StateAccepted/In press - 2017

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Adenocarcinoma
Skin
Recurrence
erbB-1 Genes
Gene Amplification
Scalp
Fluorescence In Situ Hybridization
Dissection
Neoplasms
Immunohistochemistry
human ERBB2 protein
Trastuzumab
Radiation
Pathology
Carcinoma
Therapeutics
Proteins

Keywords

  • Adnexal adenocarcinoma
  • Human epidermal growth factor receptor-2
  • Trastuzumab

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

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title = "Cutaneous adnexal adenocarcinoma with exquisite sensitivity to trastuzumab",
abstract = "Background: Cutaneous adnexal adenocarcinoma is a rare cancer that is occasionally human epidermal growth factor receptor-2 (HER-2)-positive, and demonstrates variable response to HER-2 inhibitors. Methods: We report a case of adnexal adenocarcinoma of the scalp in a 56-year-old man. He underwent wide local excision with cervical node dissection followed by radiation, but had extensive local recurrence. Results: Pathology demonstrated a poorly differentiated adnexal adenocarcinoma with HER-2 overexpression by immunohistochemistry (IHC) and high HER-2 gene amplification by fluorescence in situ hybridization. The patient was treated with trastuzumab-based therapy with dramatic response and clinical resolution of the tumor. Upon pausing trastuzumab, he developed local relapse, but had an excellent response to restarting trastuzumab monotherapy. He lacks visible disease 43 months after the initial diagnosis. Conclusion: We believe the exquisite sensitivity of the primary carcinoma and subsequent recurrence to trastuzumab therapy was due to strong HER-2 expression both at the protein and gene level.",
keywords = "Adnexal adenocarcinoma, Human epidermal growth factor receptor-2, Trastuzumab",
author = "Brown, {Timothy J.} and Sher, {David J.} and Nedzi, {Lucien A.} and Hughes, {Randall S.} and Beg, {Muhammad S.} and Jason Mull and Sarode, {Venetia R.} and Khan, {Saad A.}",
year = "2017",
doi = "10.1002/hed.24682",
language = "English (US)",
journal = "Head and Neck",
issn = "1043-3074",
publisher = "Wiley-Liss Inc.",

}

TY - JOUR

T1 - Cutaneous adnexal adenocarcinoma with exquisite sensitivity to trastuzumab

AU - Brown, Timothy J.

AU - Sher, David J.

AU - Nedzi, Lucien A.

AU - Hughes, Randall S.

AU - Beg, Muhammad S.

AU - Mull, Jason

AU - Sarode, Venetia R.

AU - Khan, Saad A.

PY - 2017

Y1 - 2017

N2 - Background: Cutaneous adnexal adenocarcinoma is a rare cancer that is occasionally human epidermal growth factor receptor-2 (HER-2)-positive, and demonstrates variable response to HER-2 inhibitors. Methods: We report a case of adnexal adenocarcinoma of the scalp in a 56-year-old man. He underwent wide local excision with cervical node dissection followed by radiation, but had extensive local recurrence. Results: Pathology demonstrated a poorly differentiated adnexal adenocarcinoma with HER-2 overexpression by immunohistochemistry (IHC) and high HER-2 gene amplification by fluorescence in situ hybridization. The patient was treated with trastuzumab-based therapy with dramatic response and clinical resolution of the tumor. Upon pausing trastuzumab, he developed local relapse, but had an excellent response to restarting trastuzumab monotherapy. He lacks visible disease 43 months after the initial diagnosis. Conclusion: We believe the exquisite sensitivity of the primary carcinoma and subsequent recurrence to trastuzumab therapy was due to strong HER-2 expression both at the protein and gene level.

AB - Background: Cutaneous adnexal adenocarcinoma is a rare cancer that is occasionally human epidermal growth factor receptor-2 (HER-2)-positive, and demonstrates variable response to HER-2 inhibitors. Methods: We report a case of adnexal adenocarcinoma of the scalp in a 56-year-old man. He underwent wide local excision with cervical node dissection followed by radiation, but had extensive local recurrence. Results: Pathology demonstrated a poorly differentiated adnexal adenocarcinoma with HER-2 overexpression by immunohistochemistry (IHC) and high HER-2 gene amplification by fluorescence in situ hybridization. The patient was treated with trastuzumab-based therapy with dramatic response and clinical resolution of the tumor. Upon pausing trastuzumab, he developed local relapse, but had an excellent response to restarting trastuzumab monotherapy. He lacks visible disease 43 months after the initial diagnosis. Conclusion: We believe the exquisite sensitivity of the primary carcinoma and subsequent recurrence to trastuzumab therapy was due to strong HER-2 expression both at the protein and gene level.

KW - Adnexal adenocarcinoma

KW - Human epidermal growth factor receptor-2

KW - Trastuzumab

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DO - 10.1002/hed.24682

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