Fast-growing cutaneous squamous cell carcinoma in a patient treated with vismodegib

Area of Science:

• Oncology
• Dermatology
• Pharmacology

Background:

• Vismodegib is a targeted therapy for locally advanced basal cell carcinoma (BCC).
• Long-term safety and potential adverse effects of hedgehog pathway inhibitors require further evaluation.
• Drug resistance and the emergence of secondary malignancies are emerging challenges in BCC treatment.

Observation:

• A 90-year-old male with locally advanced BCC of the nose was treated with vismodegib.
• The patient had a history of topical 5-fluorouracil treatment for an adjacent microinvasive SCC.
• Tumor progression and ulceration were observed 16 weeks after initiating vismodegib therapy.

Findings:

• Histological examination revealed a deeply invasive SCC.
• The case suggests a potential role for vismodegib in promoting cutaneous SCC.
• This finding aligns with emerging evidence on hedgehog pathway inhibitors.

Implications:

• Consider vismodegib as a potential promoter of cutaneous SCC.
• Recommend biopsies for new or progressive skin lesions in patients receiving hedgehog pathway inhibitors.
• Emphasize the need for vigilant monitoring and differential diagnosis in patients undergoing BCC treatment.