SCALP METASTASIS OF BREAST CANCER TREATED WITH PEMBROLIZUMAB AND LITERATURE REVIEW

Tiến Giang Đặng, Chí Hiếu Khúc, Bảo Ngọc Hoàng

Main Article Content

Abstract

Scalp metastasis from breast cancer is extremely rare. The prognosis is poor, and systemic therapy remains the primary treatment approach, although its effectiveness is limited. The disease shows little response to chemotherapy. In this paper, we report a case of a 49-year-old female patient who had completed treatment for right breast cancer six months prior and presented with a tumor in the left temporal region. Clinical examination, ultrasound, and biopsy of the lesion revealed a scalp metastasis originating from the breast. In addition to the scalp lesion, secondary metastases were also found in the cervical lymph nodes, lungs, and bones. The patient was treated with a regimen of Gemcitabine, Carboplatin, and Pembrolizumab. After three cycles, the disease showed partial response, but after six cycles, the disease progressed. Through this clinical case, we review the clinical presentation, diagnostic findings, and treatment outcomes in the literature on scalp metastasis breast cancer.

Article Details

References

Global Cancer Observatory. Accessed August 18, 2024. https://gco.iarc.fr/en
2. Chiu CS, Lin CY, Kuo TT, et al. Malignant cutaneous tumors of the scalp: a study of demographic characteristics and histologic distributions of 398 Taiwanese patients. J Am Acad Dermatol. 2007;56(3): 448-452. doi:10. 1016/ j.jaad.2006.08.060
3. Prabhu S, Pai SB, Handattu S, Kudur MH, Vasanth V. Cutaneous metastases from carcinoma breast: the common and the rare. Indian J Dermatol Venereol Leprol. 2009; 75(5):499-502. doi:10.4103/0378-6323.55395
4. Lookingbill DP, Spangler N, Sexton FM. Skin involvement as the presenting sign of internal carcinoma. A retrospective study of 7316 cancer patients. J Am Acad Dermatol. 1990;22(1):19-26. doi:10.1016/0190-9622(90)70002-y
5. Vn S. Multiple Remote Cutaneous Metastases From Male Breast Carcinoma- Cytodiagnosis Of A Case. J Cytol Histol. 2012;03(04). doi:10.4172/ 2157-7099.1000148
6. Kuwayama T, Sato T, Nakagawa T, et al. [A case of scalp metastases from breast cancer successfully treated with letrozole]. Gan To Kagaku Ryoho. 2011;38(12):2183-2185.
7. Rollins-Raval M, Chivukula M, Tseng GC, Jukic D, Dabbs DJ. An immunohistochemical panel to differentiate metastatic breast carcinoma to skin from primary sweat gland carcinomas with a review of the literature. Arch Pathol Lab Med. 2011; 135(8): 975-983. doi:10.5858/2009-0445-OAR2
8. Pembrolizumab plus Chemotherapy in Advanced Triple-Negative Breast Cancer. N Engl J Med. 2022;387(3):217-226. doi:10.1056/ NEJMoa2202809