A case of primary squamous cell carcinoma of the breast with rapid progression

Primary squamous cell carcinoma of the breast is a rare disease for which no definite treatment or prognosis has been established. This report describes our experience with one case of primary squamous cell carcinoma of the breast that ended in death after rapid progression. The patient was a 58 year old woman who visited our hospital complaining of a growing tumor and pain in the right breast. Ultrasonographically the tumor consisted of solid tumor and a large cyst. Squamous cell carcinoma was diagnosed by fine-needle aspiration cytology. Neoadjuvant CEF was given, but the tumor continued to grow, so CEF was discontinued after one course and modified radical mastectomy was performed subsequently. There was no evidence of metastasis to lymph nodes. About 5 months post operatively CT of the head and chest X-ray demonstrated metastatic lesions in the brain and lungs. Resection of the cerebral tumor was performed. About 1 month after the operation, however, a new metastatic brain tumor was found and the patient later died.     

Penile metastasis from lung cancer.

A case of metastatic tumor of the penis from lung cancer is reported. The patient, who had received a right pneumonectomy 17 months previously for a squamous cell carcinoma of the lung, complained of urinary retention and painful erection of the penis. He underwent an emergency suprapubic cystostomy. Twenty days after the procedure, he died of disseminated lung carcinoma. The autopsy demonstrated massive metastasis to the penis from squamous cell carcinoma of the lung. Penile metastasis from lung cancer is a very rare condition and only 14 cases of this secondary carcinoma have been reported.     

Metastasis to the penis in a patient with adenocarcinoma of lung, case report and literature review

Metastasis of lung cancer to the penis is very rare; it causes various clinical symptoms seriously affecting the quality of life. Early recognition and appropriate management will likely enhance survival in these patients. Here, we report a case of penile metastasis secondary to pulmonary carcinoma along with a review of the literature. One case of penile metastasis secondary to pulmonary carcinoma was detected in a 51-year-old patient who was admitted to the First Affiliated Hospital of Sun Yat-Sen University with persistent cough along with swelling of the perineum and penis. The clinical features, diagnosis, and treatment of this disease along with a relevant literature are reviewed and discussed. A MEDLINE search was performed to identify similar reports in the literature. CT scan revealed lung mass, and a glans penis ulcer and enlargement of inguinal lymph nodes was discovered upon physical examination. CT-guided percutaneous puncture of the lung mass revealed adenocarcinoma of lung, and biopsies of the glans penis ulcer and inguinal lymph nodes confirmed metastatic adenocarcinoma. The patients received chemotherapy and died of acute pulmonary embolism in less than 2 months. Metastasis of lung cancer to the penis is extremely rare. It presents an advanced form of lung cancer, and thus survival is extremely short. Although treatment of penile metastasis is almost always palliative, early recognition may enhance survival for these patients.     

Penile cancer and human papilloma virus (HPV) in a human immunodeficiency virus (HIV)-infected patient

Only a handful of cases of penile carcinoma among human immunodeficiency virus (HIV)-infected males have been reported. This is surprising insofar as other anogenital malignancies associated with human papillomavirus (HPV) are over-represented in HIV-infected men and women. Herein we describe the case of an HIV seropositive 64-year-old Caucasian with a CD4+ T-lymphocyte count of 550 cells/mm³ and an invasive squamous cell cancer of the penis. He underwent radical penectomy to treat cancer initially confined to the penile shaft and glans penis, but ultimately succumbed to complications associated with metastatic disease. HPV type 18 was identified by in situ hybridization and polymerase chain reaction (PCR) studies in the primary tumor and in groin and lung metastasis. We also briefly review current thoughts regarding the epidemiology and pathogenesis of penile cancer, particularly in the setting of HPV and HIV co-infection     

An autopsy case of lung cancer in a young adult dwarf

A 31-year-old man with peripheral squamous cell carcinoma is reported. By nature he was very small. On admission he was 140 cm tall, weighed 28 kg, and was complaining of chest pain of five years duration. A giant tumor in the right lung was found to be moderately differentiated squamous cell carcinoma. He also had congenital anomalies, such as crossed ectopic kidney with fusion, café-au-lait spots, inguinal hernia, simian line, etc. He had never been exposed to cancer-causing agents. In conclusion, genetic factors related to intrauterine growth retardation might have been linked to his oncodevelopmental mechanisms.     

Thymic cancer effectively treated by combination chemotherapy of carboplatin and etoposide with concurrent radiotherapy

A 63-year-old man was admitted to our hospital for acute heart failure. A chest CT scan revealed a large anterior mediastinal mass and pericardial effusion. Percutaneous needle biopsy showed that the mass was an advanced thymic cancer (squamous cell carcinoma). The patient was treated by combination chemotherapy of carboplatin and etoposide with concurrent radiotherapy (44 Gy). There was no severe toxicity except for grade 4 neutropenia. After 3 courses of chemotherapy, the mass showed an approximately 81% reduction in tumor size and disappearance of the pericardial effusion. Finally, the thymic cancer and small pulmonary metastatic lesions were all resected. This concurrent chemoradiotherapy can be effective against inoperable squamous cell carcinoma of the thymus.     

A case of a 10-year survivor with squamous cell carcinoma of the lung, treated with radiation after an exploratory thoracotomy

We have experienced a rare case of an unresectable lung cancer in a male patient who has survived 10 years after radiation therapy. The patient was aged 58 at the time of diagnosis. In May 1978, he was hospitalized because of an abnormal shadow in the upper left lung filed, and the diagnosis of squamous cell carcinoma was made by TBLB. Since subsequent surgery revealed an extensive tumor invasion to the large blood vessels, an exploratory thoracotomy was performed. Following postoperative 60 Gy radiation therapy, tumor regression was observed on examination of chest x-ray films. In July, 1988, 10 years and 3 months after this surgery, a back pain developed due to the recurrence of the tumor, and radiation therapy was given again. This relieved the pain. As of December 1988, he receives treatment on an outpatient basis and his performance status has been excellent.     

Case of double primary carcinoma of the lung and ureter

A 73-year-old man visited our hospital complaining of chest distress in September 1979. A chest X-ray film showed a tumor shadow in the left lung and left inferior lobectomy was performed. The tumor measured 50 X 40 X 30 mm; it was diagnosed as large cell carcinoma. In November 1980 the patient suddenly noticed macroscopic hematuria although there had been no microscopic hematuria at his first visit. Ultrasound-guided percutaneous pyelography confirmed complete obstruction of the left ureter and he underwent left ureteronephrectomy. The papillary tumor, measuring 23 cm, was diagnosed as transitional cell carcinoma.     

Sintilimab-Induced Diabetic Ketoacidosis in a Patient with Radiation and Multichemorefractory Penile Cancer: A Case Report and Literature Review

Penile squamous cell carcinoma (PSCC) is a rare disease. The treatment options for advanced penile cancer are often limited, and the prognosis remains poor. We reported a 52-year-old male recurrent and metastatic PSCC patient with high PD-L1 expression (90%) and TMB (14.4 muts/Mb). He had undergone penectomy, bilateral inguinal lymph node dissection, and excision of the abdominal wall mass. Despite cisplatin-based concurrent chemoradiotherapy and sequential chemotherapy with docetaxel plus cisplatin then being carried out, the carcinoma still progressed. The patient then obtained progression-free survival with continuous sintilimab, although he experienced the new onset of ICI-induced diabetes after 24 cycles of sintilimab and required sustained insulin treatment. He had negative type 1 diabetes-associated autoantibodies and the susceptible HLA genotype DR3-DQ2 haplotype. This is the first patient with radiation and multichemorefractory PSCC who has obtained the remarkable anti-tumor effect of partial regression exceeding 32 months during continuous sintilimab and anlotinib treatment.     

79例肺肉瘤样癌的临床特征及预后分析

目的 通过分析肺肉瘤样癌（pulmonary sarcomatoid carcinoma, PSC）的临床资料,探讨其临床特征及预后因素。方法 回顾性分析79例PSC患者的临床资料,采用SPSS19.0统计软件对患者的性别、年龄、是否有吸烟史、肿瘤的原发部位、位置类型、肿瘤大小、T分期、有无淋巴结转移、有无远处转移、TNM分期、组织学亚型、治疗方法及是否手术等因素进行预后分析。采用Kaplan-Meier法进行生存分析,采用Log rank法进行单因素分析,采用Cox比例风险回归模型进行多因素分析。结果 与腺癌、鳞癌、小细胞癌等肺癌亚型相似,PSC患者多以咳嗽、胸闷、发热、痰中带血、咯血、胸痛等为初诊症状。本研究中患者的1、2、3年总生存率分别为25.3%、8.0%、4.8%,中位生存时间为8.0月。单因素分析显示,年龄、肿瘤大小、T分期、有无远处转移、TNM分期、治疗方法及是否手术是影响预后的因素。结论 PSC是一类少见的、侵袭性较高的非小细胞肺癌,预后差。与其他肺部肿瘤相比,PSC缺乏典型的临床表现,诊断主要依靠病理学和免疫组织化学方法。本研究中患者的年龄、肿瘤大小和治疗方法是影响预后的独立因素,手术联合放化疗是首选治疗方法。     

Large cell neuroendocrine carcinoma of the ampulla of vater with adenocarcinoma and squamous cell carcinoma components

A 73-year-old woman visited our hospital complaining of general fatigue and jaundice. Laboratory tests revealed an elevated total bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and γ-glutamyltransferase. Computed tomography and magnetic resonance imaging demonstrated a mass lesion at the ampulla of Vater with dilatation of the common bile duct and main pancreatic duct. Percutaneous transhepatic cholangiography revealed dilatation of the bile duct and a negative filling defect due to the tumor. Pancreatoduodenectomy was performed. The specimen included an ulcerated firm tumor of the papilla Vater. The surface of the ampulla consisted of well-differentiated papillary adenocarcinoma, whereas the deep layer, such as submucosal or muscular layer, contained large cell neuroendocrine carcinoma and squamous cell carcinoma. Immunohistochemistry revealed that the large cell neuroendocrine carcinoma component was positive for chromogranin A, synaptophysin and CD56. The patient died from multiple liver and bone metastases 13 months after surgery. This is a very rare case of a large cell neuroendocrine carcinoma accompanied by adenocarcinoma and squamous cell carcinoma components.     

A clinical case of the penile metastasis from the rectal carcinoma

Background

Penile metastases are rare and usually secondary to genitourinary and colorectal cancer.

Case report

We present a case of a 77-year-old man with penile metastasis who was operated for rectal carcinoma. He was referred to our clinic for penile ulcerous lesion, semierectile penis and voiding dysfunction. Imaging studies showed nodular lesion at glans penis and multiple bone metastases. He did not respond to chemoradiotherapy and he had bad prognosis.

Conclusions

Imaging methods and biopsy may help to clarify the diagnosis but the treatment modalities are insufficient in these patients.     

Metastatic lung adenocarcinoma in a 20-year-old patient

Lung cancer is rare disease in patients under 25 years of age. It typically occurs in older patients with a history of tobacco use. This case concerns a 20-year-old man with no history of tobacco use who complained of several months of cough and lower back pain and an 11.3-kg weight loss. He was treated for pneumonia after a chest radiograph showed total opacification of the right lung. Computed tomography imaging subsequently revealed a superior right hilar mass and mediastinal lymphadenopathy. Further imaging studies showed diffuse metastatic disease. Mediastinal biopsy showed poorly differentiated epithelioid tumour with desmoplastic stromal reaction, neutrophil infiltration, and squamous differentiation. Tissue immunostaining confirmed a non-small-cell lung cancer. Unfortunately, despite aggressive therapy, the patient’s disease progressed, and he died within 9 months. In this paper, we hope to illustrate the unique challenges in diagnosing and treating young patients with metastatic lung cancer.     

A case of coexisting malignant mesothelioma and squamous cell carcinoma of the lung

We experienced a case of malignant mesothelioma with squamous cell carcinoma of the lung concurrently. A 40-year-old man presented with dyspnea. A massive pleural effusion was found by X-ray in the right side of his chest. Transcutaneous pleural biopsy yielded a diagnosis of malignant mesothelioma(IMIG cT4N0M0, Stage IV ). At the same time, his chest CT revealed tumor in the right hilar lesion. Transbronchial lung biopsy yielded a diagnosis of squamous cell carcinoma of the lung (cT3N0M0, Stage III B). Our diagnosis was double cancer, malignant mesothelioma and lung cancer. Chemotherapy with carboplatin, gemcitabine and radiation therapy was performed, but the patient died from deterioration of his systemic condition. We encountered a rare case of double cancer. More attention must be paid in making a diagnosis of malignant mesothelioma and lung cancer.     

Hand-assisted laparoscopic adrenalectomy to a solitary adrenal metastasis from lung cancer

A 75-year-old man with right chest pain was diagnosed with primary lung cancer in the right apical portion, and was treated with chemoradiotherapy because of a synchronous left adrenal tumor of 1.6 cm. Since the adrenal tumor did not increase in size for three months and there were no other relapses, the right upper lobectomy of the lung with the excision of the chest wall was performed. Afterward, an enlargement of the left adrenal tumor was encountered; he was admitted to our hospital for an operation. For the metastatic adrenal tumor from lung cancer, we performed a hand-assisted laparoscopic adrenalectomy. He recovered rapidly and returned to the previous hospital in two weeks after the operation. After the first report in 1992, the laparoscopic adrenalectomy has been established as the curative operation to adrenal benign tumor. The indication is being expanded to the malignancy because of the improvement of operation techniques and advancement of the operation equipments. We conclude that the laparoscopic adrenalectomy for malignant tumor is a safe, curative, and clinically useful surgical technique.     

Treatment with low-dose cyclophosphamide and radiation therapy for advanced non-small lung cancer in elderly patient

The patient was a 70-year-old man who had unresectable locally advanced large-cell lung cancer with aorta and mediastimun invasion(T4N2M0). He had left shoulder pain and obstructive pneumonitis caused by lung cancer.We performed 60 Gy/ 35 Fr radiotherapy with concurrent low-dose cyclophosphamide(5mg/body/day). After chemoradiotherapy, the main tumor has been decreasing gradually. Seven years and six months after chemoradiotherapy, we detected the soft tissue mass lesion on his chest CT, but could not find abnormal accumulation on his 18F-FDG-PET. The local control was improved gradually and he had no respiratory symptoms or pain for a long period. There has been no recurrence for 10 years now. We recommend radiation and/or low-dose chemotherapy as useful treatments for the advanced non-small lung cancer in elderly patients.     

Primary squamous cell carcinoma of the breast: Sensitivity to cisplatinum-based chemotherapy

Primary squamous cell carcinoma (SCC) of the breast is a rare malignancy whose optimal treatment and prognosis anre unknown. A patient with SCC whose tumor responded dramatically to chemotherapy as part of multimodal treatment is presented. A 61-year-old woman had a palpable 5.5-cm tender left breast mass with overlying skin edema and erythema and irregular margins by mammography. Fine needle aspiration revealed malignant squamous cells with keratinization; incisional biopsy confirmed SCC. Extensive evaluation for an extramammary primary site of disease was negative. Neoadjuvant cisplatinum and 5-fluorouracil (5-FU) led to tumor shrinkage and complete resolution of pain and erythema. Modified radical mastectomy with post-operative chest wall radiation were performed. Neither residual invasive carcinoma nor metastatic nodal disease was found, though intraductal carcinoma with marked squamous features was identified. The patient remains disease-free 2.5 years after diagnosis. Cisplatinum-based chemotherapy should be considered in the treatment regimen of this disease.     

Definitive Chemoradiotherapy for Locally Advanced,Lymph-node Positive,Nonmetastatic Penile Squamous Cell Carcinoma

IntroductionLocally advanced penile cancer is rare, with few reported studies on the therapeutic role of chemoradiotherapy. We sought to characterize the efficacy and toxicity of definitive chemoradiotherapy for locally advanced, node-positive, squamous cell carcinoma of the penis.Materials and MethodsSix patients who had refused or were ineligible for surgical resection of clinically staged node-positive squamous cell penile cancer were treated with definitive chemoradiotherapy using either weekly cisplatin or 2 cycles of mitomycin C/5-fluorouracil. The mean radiation dose to the primary sites, involved lymph nodes, involved nodal basins, and uninvolved nodal basins was 57.2, 55.0, 49.7, and 42.3 equivalent dose delivered in 2-Gy fractions.ResultsWith a median follow-up of 7.2 years, 4 of the 6 patients were recurrence-free and 2 had developed recurrence. One of the latter died of penile-specific complications after salvage surgery to treat the recurrence. Of the 6 patients, 4 experienced long-term penectomy-free survival. No patient developed distant metastasis after therapy. The 4 patients with durable penectomy-free survival reported excellent urologic, sexual, and bowel function, as assessed by various validated patient-reported outcome surveys and subjective reports. One of the 2 patients with recurrence was successfully salvaged with penectomy. Lymphedema and stricture were not reported by any of the patients.ConclusionsDefinitive chemoradiotherapy is an effective organ-sparing treatment of node-positive penile cancer, with durable disease control and maintenance of quality of life. This treatment option should be offered to carefully counseled patients within the context of expert multidisciplinary teams and should be incorporated into expert consensus treatment guidelines.     

Squamous cell carcinoma of the anal canal in the elderly showing complete response following radiotherapy--a case report

We reported an elderly case of squamous cell carcinoma of the anal canal which showed complete response following radiotherapy alone. An 86-year-old man complaining of anal bleeding and pain was admitted. Colonoscopy showed a type 1 tumor just above the dentate line. Biopsy revealed squamous cell carcinoma. Serum SCC Level before treatment was elevated (8.4 ng/mL). Magnetic resonance imaging did not show any metastatic lesions. Since the patient and his family members refused a surgical intervension and chemotherapy, he received an external radiotherapy (total dose: 60 Gy) to the pelvic space and showed complete response after radiotherapy. He is alive without evidence of recurrence about three years after the radiation, although serum SCC is slightly elevated.