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Case Report
Diagnostic and management dilemma in basaloid squamous cell carcinoma of lung showing significant response to immunotherapy: Case report and literature review
1 Medical Registrar (AT), Medical Oncology, Northwest Cancer Centre, Tamworth Hospital, Tamworth, NSW, Australia
2 Calvary Mater Newcastle Hospital, Waratah, NSW, Australia
3 Resident Medical Officer, General Surgery, Tamworth Hospital, Tamworth, NSW, Australia
4 Senior Resident Medical Officer, Emergency Department, Tamworth Hospital, Tamworth, NSW, Australia
5 Staff Specialist, Medical Oncology, Northwest Cancer Center, Tamworth Hospital, Tamworth, NSW, Australia
Address correspondence to:
Prajwol Shrestha
Department of Medical Oncology, Calvary Mater Newcastle Hospital, Corner Edith and Platt Street, Waratah, NSW 2298,
Australia
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Article ID: 100070Z10PS2020
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How to cite this article
Shrestha P, Mackenzie L, Taneja K, George MK, Rai S. Diagnostic and management dilemma in basaloid squamous cell carcinoma of lung showing significant response to immunotherapy: Case report and literature review. J Case Rep Images Oncology 2020;6:100070Z10PS2020.ABSTRACT
Introduction: Basaloid squamous cell lung carcinoma is a rare subtype of non-small cell lung cancer, accounting for 3.9–5.2% of all lung squamous carcinomas. The prognosis is still debated and there is limited evidence regarding the efficacy of immunotherapy in this relatively uncommon population.
Case Report: We report a case of basaloid squamous cell lung carcinoma, which was initially diagnosed as small cell carcinoma before completion of all immunohistochemical tests. The patient received seven doses of nivolumab after progression on chemotherapy. Although the treatment had to be interrupted due to colitis, she had a near-complete response.
Conclusion: Besides illustrating the importance of immunohistochemical staining to aid in accurate diagnosis, this case also demonstrates the deep and durable response to nivolumab. The patient responded significantly better than the reported median progression free survival for squamous cell carcinoma with second line nivolumab. Although this case report demonstrates a remarkable response, it will be important to validate the predictive response to nivolumab in large randomized studies.
Keywords: Basaloid squamous cell carcinoma, Immunotherapy, Lung cancer, Nivolumab, Squamous cell lung carcinoma
SUPPORTING INFORMATION
Acknowledgments
Dr. A Pasupathy for slides from Pathology North.
Author ContributionsPrajwol Shrestha - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Laura Mackenzie - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Karan Taneja - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Mathew Kattathra George - Conception of the work, Design of the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Sunil Rai - Conception of the work, Design of the work, Acquisition of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2020 Prajwol Shrestha et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
