Intralesional methotrexate and new approaches for neoadjuvance treatment in squamous cell periocular carcinoma

Arch Soc Esp Oftalmol (Engl Ed). 2024 Nov;99(11):517-521. doi: 10.1016/j.oftale.2024.07.007. Epub 2024 Jul 20.

Abstract

This study arises from the need to understand the different therapies for cutaneous squamous cell carcinoma (SCC), especially in challenging clinical situations where conventional therapeutic options may not be optimal. The purpose of the study is to assess the efficacy and safety of intralesional methotrexate (MTX) as neoadjuvant therapy in the treatment of periocular SCC. The outcome of a patient after two separate intralesional MTX infiltrations 2 weeks apart is described. Therapeutic response was evaluated, achieving a significant reduction in tumor size and subsequently performing surgical excision of the residual lesion. The procedure was well tolerated, with no local or distant recurrences in the follow up. Intralesional MTX may be an effective and safe option in the neoadjuvant treatment of periocular SCC. Furthermore, we highlight the growing importance of immunotherapy in the approach to SCC and the need to familiarize specialists with these new treatments.

Keywords: Carcinoma escamoso cutáneo; Cutaneous squamous cell carcinoma; Cáncer cutáneo; Eyelids; Inmunoterapia; Inmunotherapy; Intralesional neoadjuvant; Neoadyuvancia intralesional; Párpados; Skin cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antimetabolites, Antineoplastic* / administration & dosage
  • Antimetabolites, Antineoplastic* / therapeutic use
  • Carcinoma, Squamous Cell* / drug therapy
  • Eyelid Neoplasms* / drug therapy
  • Female
  • Humans
  • Injections, Intralesional*
  • Male
  • Methotrexate* / administration & dosage
  • Methotrexate* / therapeutic use
  • Neoadjuvant Therapy
  • Skin Neoplasms / drug therapy

Substances

  • Methotrexate
  • Antimetabolites, Antineoplastic