Squamous Cell Carcinoma, Metastatic Prostatic Adenocarcinoma

A 77-year-old Caucasian male with a history of locally advanced prostate cancer on androgen deprivation therapy presented to BPEI for evaluation of a right lower lid lesion present for six weeks that did not improve with conservative treatment. Exam revealed a firm, painless lesion at the medial canthus. Patient underwent incisional biopsy which revealed squamous cell carcinoma. CT orbit imaging revealed extensive inferior orbital involvement. Given patient’s ongoing prostate cancer management and patient’s desire to avoid surgical intervention, the decision was to pursue Anti-PD1 immunotherapy. Patient received Cemiplimab for eight months with complete resolution, thus sparing patient from extensive exenteration. Patient achieved radiological resolution with Cemiplimab. Over the course of a year, patient underwent radiation therapy for metastatic prostate adenocarcinoma involving bone and escalation to chemotherapy. Patient then presented with firm right preauricular mass. CT-neck revealed new lobulated lesion of the right parotid gland and large enhancing mass of the right inferolateral orbit. Fine needle aspiration biopsy of the right parotid gland and incisional biopsy of the right inferolateral orbit revealed carcinoma consistent with metastasis and prostate primary. His treatment course is documented in this presentation

Presentation Date: 11/19/2020

Issue Date: 05/28/2021