Massive Malignant Transformation in a Patient with Hidradenitis Suppurativa during Anti-Tumor Necrosis Factor Treatment.
Gabija Rudzikaitė, Jorinta Jokubaitė, Dominykas Markevičius and 2 others
PMID 40184513WHAT IT FOUND
One 53-year-old man with hidradenitis suppurativa taking adalimumab developed squamous cell carcinoma.
Adalimumab was stopped, antibiotics were given for resistant bacteria, radiation and wide excision with grafts were used, and no recurrence was seen at 4 months.
Key findings
01A 53-year-old man with a 16-year history of severe hidradenitis suppurativa who had taken adalimumab 40 mg weekly for 5 years developed new rapid ulceration and biopsy-confirmed well-differentiated squamous cell carcinoma.
02The patient received several treatments together: adalimumab was discontinued, intravenous antibiotics were given for multidrug-resistant Acinetobacter baumannii, local antiseptics were used, radiation therapy was followed by wide excision creating a 20 × 20 cm defect, and reconstruction used vacuum-assisted closure, wound irrigations, dressings, eight staged debridements, and four split-skin grafting procedures.
034 months after primary tumor excision, computed tomography showed no disease progression, and at the time of writing the patient had appointments every 3 months and no malignant recurrence was observed.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is one patient, so it cannot show that any treatment works or that the outcome would repeat in others. Several treatments were given together, including stopping adalimumab, antibiotics, local antiseptics, radiation, wide excision, vacuum-assisted closure, wound irrigations, dressings, staged debridements, and split-skin grafts, so the contribution of any single component cannot be separated. The report describes only this patient and does not compare him with other patients. Follow-up was limited: the computed tomography scan was done 4 months after excision, and the report stops at the time of writing, so longer-term recurrence risk is unknown. The Discussion recommendations about biopsy, smoking cessation, and HPV vaccination are expert suggestions, not outcomes tested in this case.
The easy way to misread this
Do not read this as evidence that stopping adalimumab, antibiotics, radiation, wide excision, vacuum-assisted closure, debridements, or grafting prevented recurrence. This is a single case with several treatments given together and no comparison group, so it cannot separate the effect of any one treatment.