Favorable response to combined androgen blockade for metastatic cutaneous apocrine carcinoma: a case report

Takashi Imajima,Yudai Shinohara,Hitoshi Kusaba,Eishi Baba,Hidetaka Yamamoto,Mamoru Ito,Kenji Tsuchihashi,Koichi Akashi,Hiroshi Ariyama,Yoshinao Oda

doi:10.1097/ij9.0000000000000105

Takashi Imajima, Yudai Shinohara + Show 8 more

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https://doi.org/10.1097/ij9.0000000000000105

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Abstract

Introduction: Most cases of cutaneous apocrine carcinoma (CAC) express androgen receptor. Androgen signal is thought to have a relationship on the survival and cell growth of the tumor. Presentation of Case: A 53-year-old man with a red superficial nodule on the left axilla and a back pain was diagnosed with CAC in the left axilla with multiple bone and bone marrow metastases. After cytotoxic chemotherapy for around 4 years, severe anemia, thrombocytopenia, and disseminated intravascular coagulation progressed. We started combined androgen blockade by bicaltamide and degarelix, and the therapy had successfully maintained stable disease for more than 6 months. Discussion: Most cases of CAC express androgen receptor. Androgen signal could have a relationship on the survival and cell growth of the tumor. Conclusion: Antiandrogen therapy for androgen-receptor positive CAC is a promising therapeutic option.

Highlights

Most cases of cutaneous apocrine carcinoma (CAC) express androgen receptor
CAC is one of the adenocarcinomas originating from apocrine glands that mainly arises in the axilla and anogenital region, which are rich in apocrine glands
Apocrine gland adenocarcinoma is reported to have a relatively nonaggressive nature, lymph node metastasis is found in 40%–50% of the patients at initial diagnosis[13,14]

Summary

Introduction

Most cases of cutaneous apocrine carcinoma (CAC) express androgen receptor. Androgen signal is thought to have a relationship on the survival and cell growth of the tumor. Peripheral blood examination showed immature white and red blood cells, which suggested bone marrow involvement of the tumor. He had no notable past history and family history. The blood examination showed evidence of disseminated intravascular coagulation (DIC) (fibrinogen 205 mg/dL, prothrombin time-international normalization ratio (PT-INR) 1.24, fibrin/fibrinogen degradation products (FDP) 41.9 μg/mL, D-dimer 11.4 μg/mL), suggesting progression of bone marrow metastases. He was admitted to our department for third-line treatment in April 2019. This case report is reported in line with the SCARE 2018[12]

Discussion

Conclusion

Ethical approval

Findings

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