Basal-Cell Carcinoma: A Case Unmasked by Systemic Fluorouracil Therapy

• Published in: JAMA : the journal of the American Medical Association Vol. 235; no. 22; pp. 2416 - 2417
• Main Authors: Scialla, Salvatore J, Miskoff, Richard A
• Format: Journal Article
• Language: English
• Published: United States American Medical Association 31-05-1976
• Subjects: Administration, Topical; Carcinoma, Basal Cell - diagnosis; Carcinoma, Basal Cell - drug therapy; Diarrhea - chemically induced; Fluorouracil - administration & dosage; Fluorouracil - pharmacology; Fluorouracil - therapeutic use; Humans; Injections, Intravenous; Leukopenia - chemically induced; Liver Neoplasms - drug therapy; Male; Middle Aged; Pruritus - chemically induced; Skin Neoplasms - diagnosis; Skin Neoplasms - drug therapy; Stomatitis - chemically induced; Thrombocytopenia - chemically induced
• ISSN: 0098-7484; 1538-3598
• DOI: 10.1001/jama.1976.03260480036029

TOPICAL fluorouracil has been effective for the management of superficial basal-cell carcinoma. This topical chemotherapy can also unmask otherwise undiagnosable lesions.1 A patient experienced an inflammatory reaction around a skin lesion while taking intravenous fluorouracil, which prompted us to perform a biopsy of the area.Report of a CaseA 56-year-old man, after a partial colectomy for adenocarcinoma of the sigmoid colon in 1971, experienced anorexia and weight loss in September 1974. He was found to have liver metastasis and was given floxuridine (FUDR) by hepatic artery infusion. After this infusion, maintenance therapy with fluorouracil, 1 gm intravenously per week, was started. Following the third dose of fluorouracil, he experienced diarrhea, stomatitis, a facial skin eruption, and intense inflammation and pruritus involving a previously asymptomatic, inconspicuous papular skin lesion on the chest.Physical examination showed a macular erythematous facial eruption. In addition, a prominent nodular ulcerative lesion not noted