Objective Clinical and Radiological Response under Sunitinib in aCase of Thigh Hidradenocarcinoma

A 56-year-old male was treated by local surgery in 1968 and 2005 for a left thigh lesion. A 2ndlocal relapse occurred in 2015 and wastreated by complete macroscopic surgery with histology concluding to a hidradenocarcinoma. A 3rdlocoregional relapse occurredin October 2018, with the presence of inflammatory ulcerated lesions. A 2ndhistology and immunohistochemistry exam showed aproliferation positive for CK, CK5, and p63 suggesting the diagnosis of hidradenocarcinoma. The patient was treated by 3 lines ofchemotherapy, 1stby Adriamycin, 2ndby carboplatin-paclitaxel, and then 3rdby oral capecitabine, leading to a stable clinical diseasebut without a clinical benefit. A locoregional plus metastatic lung progression was observed in March 2019, with the presence oflung nodules and retroperitoneal lymph nodes, multiple skin left thigh and left inguinal ulcerated lesions. The patient receivedthen in 4thline in April 2019 oral sunitinib at 50 mg daily, with 4 weeks therapy/2 weeks pause. Side effects were represented bymucositis, anorexia, weight loss, and fatigue. We observed since the 1stweek of therapy a fast response, with a decrease of theulcerated lesions, a skin loss, and deep hemorrhagic areas. CT-scan showed after 2 weeks of sunitinib an objective response onboth locoregional and metastatic lesions.