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Case Reports
. 2020 Nov;48(11):300060520964355.
doi: 10.1177/0300060520964355.

Sorafenib for treating head and neck adenocarcinoma of unknown primary site: a case report

Jingxian Chen  1 , Chien-Shan Cheng  2   3 , Jie Chen  4 , Lingling Lv  1 , Xiaoheng Shen  1 , Lan Zheng  1
Affiliations
Case Reports

Sorafenib for treating head and neck adenocarcinoma of unknown primary site: a case report

Jingxian Chen et al. J Int Med Res. 2020 Nov.

Abstract

The aim of the present study was to report a rare case of head and neck adenocarcinoma with an unknown primary site in a 59-year-old man. After disease progression followed by multiple cycles of chemotherapy and radiotherapy, genetic screening using next-generation sequencing identified vascular endothelial growth factor A amplification and the TP53 R209Kfs mutation. Treatment with the multi-targeted protein kinase inhibitor sorafenib controlled the patient's symptoms and improved his quality of life.

Keywords: Cancer of unknown primary; adenocarcinoma; adverse events; head and neck cancer; next-generation sequencing; sorafenib.

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Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Figures

Figure 1.
Figure 1.
A lesion in the left submandibular gland was detected via plain computer tomography (a), T1-weighted magnetic resonance imaging (b), T2-weighted magnetic resonance imaging (c), and contrast-enhanced computed tomography (d). Subcutaneous soft tissue mass in the left neck with increased metabolism on positron emission tomography–computed tomography (e–h).
Figure 2.
Figure 2.
Hematoxylin and eosin staining of the subcutaneous soft tissue mass biopsy specimen revealing adenocarcinoma. Magnification, ×50 (a), ×200 (b), and ×400 (c). Staining for cytokeratin AE1/AE3 (d), CK7 (e), and negative-control antibodies (f).
Figure 3.
Figure 3.
Submandibular contrast-enhanced computed tomography (a), T1-weighted magnetic resonance imaging (b), and T1-weighted magnetic resonance imaging (c) revealed a thickened and enhanced soft tissue mass on the left side of the neck after three cycles of paclitaxel/cisplatin chemotherapy. Enhanced computed tomography before radiotherapy (d) and after radiotherapy and three cycles of paclitaxel monotherapy (e) revealed disease progression.
Figure 4.
Figure 4.
Facial swelling 2 days before sorafenib treatment (a) and 2 days after the start of treatment (b). Complete resolution of swelling 1 week after the start of sorafenib treatment (c). Facial edema 10 days after the start of sorafenib treatment (d) and relief (e) after the intervention.
Figure 5.
Figure 5.
Stable disease on computed tomography (a), T1-weighted magnetic resonance imaging (b), and T2-weighted magnetic resonance imaging (c).
See this image and copyright information in PMC

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