Cemiplimab for metastatic squamous cell carcinoma of the orbit, periocular adnexa, and thigh

ABSTRACT

The current case presentation highlights the potential of cemiplimab, a programmed cell death protein-1 (PD-1) inhibitor, as first-line treatment for periocular metastatic cutaneous squamous cell carcinoma (SCC) without requiring curative surgery or radiotherapy. A 64-year-old male presented with a progressing 4.5 × 3.0 cm left upper eyelid lesion initially diagnosed as psoriasis. Work-up revealed cutaneous SCC with tumor invasion into extraconal fat and lacrimal gland, and metastasis to the left parotid lymph node. The patient also presented with a suspicious lesion on his left medial thigh found to be a second primary on pathology. To avoid orbital exenteration and treat the multifocal disease, the patient was started on intravenous cemiplimab immunotherapy. Following six doses, repeated FGD-PET-CT revealed a complete response of the left eyelid lesion and residual low-grade hypermetabolic activity of the left medial thigh lesion. Biopsy confirmed chronic inflammation and fibrosis with no signs of malignancy. This unique case with dual primary cutaneous SCC provides support for cemiplimab in treating locally invasive periocular SCC, and potentially abrogating the need for highly morbid exenteration procedures to preserve binocular vision.

KEYWORDS:

• Cemiplimab
• cutaneous squamous cell carcinoma
• immunotherapy
• metastasis

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.

Meeting presentation

International Society of Ocular Oncology (ISOO) Meeting (June 2021; Virtual).

Patient consent

Consent was obtained directly from the patient in writing to utilize their case for education and scientific publication purposes. Consent included permission to the publish pertinent personal information, case details, and photographs as necessary.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.