Intralesional Methotrexate Injection for the Treatment of Epithelial Crateriform Tumor
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Background: Intralesional methotrexate injection (IL-MTX) is an appropriate strategy for treat- ing epithelial crateriform tumors (ECTs) when surgical excision can result in functional or cos- metic defects; however, not all ECTs are responsive to this treatment. Objective: This study aimed to evaluate the effectiveness of IL-MTX for ECTs and to determine the differences in clinical response according to the pathological features. Methods: The medical records of patients treated with IL-MTX for their ECTs were retrospec- tively reviewed. Effectiveness was evaluated in terms of size reduction and flattening. Results: Twenty-five cases of ECTs with biopsy were included in this study. Eight cases of kera- toacanthoma (KA) and 15 cases of squamous cell carcinoma (SCC) were identified, but 2 cases could not be clearly distinguished. Seventeen patients (68%) showed a response after injection, and response rate in KA and SCC were 75% (6/8) and 60% (9/15), respectively. Nine patients showed complete resolution with IL-MTX. Patients received 3 injections, and regression was obser ved in 7.56 weeks after the first injection. According to histopathological results, patients with KA and SCC received 2 and 3.33 injections, respectively, and complete resolution was obser ved after 7 and 7.67 weeks, respectively. Conclusion: IL-MTX is safe and effective, and could be considered as a useful non-surgical treatment option for ECTs. Both KA and crateriform SCC showed good response; However, KA showed a better response.
Abstract
Background: Intralesional methotrexate injection (IL-MTX) is an appropriate strategy for treat- ing epithelial crateriform tumors (ECTs) when surgical excision can result in functional or cos- metic defects; however, not all ECTs are responsive to this treatment. Objective: This study aimed to evaluate the effectiveness of IL-MTX for ECTs and to determine the differences in clinical response according to the pathological features. Methods: The medical records of patients treated with IL-MTX for their ECTs were retrospec- tively reviewed. Effectiveness was evaluated in terms of size reduction and flattening. Results: Twenty-five cases of ECTs with biopsy were included in this study. Eight cases of kera- toacanthoma (KA) and 15 cases of squamous cell carcinoma (SCC) were identified, but 2 cases could not be clearly distinguished. Seventeen patients (68%) showed a response after injection, and response rate in KA and SCC were 75% (6/8) and 60% (9/15), respectively. Nine patients showed complete resolution with IL-MTX. Patients received 3 injections, and regression was obser ved in 7.56 weeks after the first injection. According to histopathological results, patients with KA and SCC received 2 and 3.33 injections, respectively, and complete resolution was obser ved after 7 and 7.67 weeks, respectively. Conclusion: IL-MTX is safe and effective, and could be considered as a useful non-surgical treatment option for ECTs. Both KA and crateriform SCC showed good response; However, KA showed a better response.
참고문헌 (17)
- Ogita A, "Histopathological diagnosis of epithelial crateriform tumors : keratoacanthoma and other epithelial crateriform tumors", J Dermatol, 43, pp.1321~1331 (2016)
- Beham A, "Keratoacanthoma : a clinically distinct variant of well differentiated squamous cell carcinoma", Adv Anat Pathol, 5, pp.269~280 (1998)
- Kwiek B, "Keratoacanthoma(KA) : an update and review", J Am Acad Dermatol, 74, pp.1220~1233 (2016)
- Gualdi G, "Intralesional methotrexate for the treatment of advanced keratinocytic tumors : a multi-center retrospective study", Dermatol Ther(Heidelb), 10, pp.769~777 (2020)
- Searle T, "Intralesional methotrexate in dermatology : diverse indications and practical considerations", Dermatol Ther, 34, pp.e14404~ (2021)
- Salido-Vallejo R, "Clinical utility of intralesional methotrexate to distinguish crateriform keratinocytic tumors before surgery", J Dtsch Dermatol Ges, 20, pp.102~105 (2022)
- Olsen EA, "The pharmacology of methotrexate", J Am Acad Dermatol, 25, pp.306~318 (1991)
- Annest NM, "Intralesional methotrexate treatment for keratoacanthoma tumors : a retrospective study and review of the literature", J Am Acad Dermatol, 56, pp.989~993 (2007)
- Smith C, "Intralesional methotrexate for keratoacanthomas : a retrospective cohort study", J Am Acad Dermatol, 83, pp.904~905 (2020)
- Bergón-Sendín M, "Effectiveness of neoadjuvant intralesional methotrexate in cutaneous squamous cell carcinoma : a prospective cohorts study", Dermatol Ther, 35, pp.e15233~ (2022)
- Bergón-Sendín M, "Histological findings after intralesional methotrexate treatment in cutaneous squamous cell carcinoma", Dermatol Ther, 33, pp.e14377~ (2020)
- Bergón-Sendín M, "Cutaneous ultrasound for tumor thickness measurement in squamous cell carcinoma : the effect of neoadjuvant intralesional methotrexate in 40 patients", Dermatol Surg, 46, pp.530~536 (2020)
- Salido-Vallejo R, "Neoadjuvant intralesional methotrexate in cutaneous squamous cell carcinoma : a comparative cohort study", J Eur Acad Dermatol Venereol, 30, pp.1120~1124 (2016)
- Vega-González LG, "Successful treatment of squamous cell carcinoma with intralesional methotrexate", JAAD Case Rep, 24, pp.68~70 (2022)
- Kiss N, "Intralesional therapy for the treatment of keratoacanthoma", Dermatol Ther, 32, pp.e12872~ (2019)
- Yoo MG, "Intralesional methotrexate for the treatment of keratoacanthoma : retrospective study and review of the Korean literature", Ann Dermatol, 26, pp.172~176 (2014)
- Kremer JM, "Methotrexate pharmacogenomics", Ann Rheum Dis, 65, pp.1121~1123 (2006)
