Lumpectomy Combined with Adjuvant Radiotherapy Could Be a Treatment Option for Primary Squamous Cell Carcinoma of the Breast

Background. To investigate the outcomes of primary squamous cell carcinoma (PSCC) of the breast undergoing radical surgery with or without adjuvant radiotherapy (RT). Materials and Methods. A population cohort with histologically diagnosed PSCC of the breast was identified from the SEER database. The Kaplan–Meier method and Cox-regression proportional hazards model was used to assess the impact of surgical types with or without adjuvant RT on the cause-specific survival (CSS) and overall survival (OS). A retrospective analysis of PSCC between Jan 2010 and Dec 2018 from our institute was performed. Results. A total of 515 patients with PSCC of the breast were included, 254 patients treated with mastectomy (MAST) alone, 78 with MAST + RT, 87 with lumpectomy (LUMP) alone, and 96 with LUMP + RT. The median follow-up time was 118 months (range: 0–379 months). In the multivariate Cox analyses, LUMP + adjuvant RT was an independent prognostic factor for CSS (p = 0.028) and OS (p = 0.048). Patients treated with LUMP + RT had better survival rates than patients who underwent lumpectomy (CSS, p = 0.034; OS, p = 0.0004), MAST alone (CSS, p = 0.0001; OS, p < 0.0001), and MAST + RT (CSS, p = 0.0001; OS, p = 0.0078), while postmastectomy RT did not significantly improve OS (p = 0.062) and CSS (p = 0.67) when compared to MAST alone. In addition, a total of 28 patients with PSCC of the breast were identified from our institute. All of these patients presented with estrogen receptor-negative type, and three of them had HER-2-positive PSCC; the median tumor size was 3 cm (range: 0.5–15 cm). Eight patients were treated with LUMP + adjuvant RT, thirteen with MAST, and seven with MAST + RT. Until the last follow-up of Sep 2021, 26 patients with PSCC were still alive and free of breast cancer, excepting that one patient treated with MAST and one patient with MAST + RT died from breast cancer. Conclusion. PSCC of the breast after radical surgery has a poor prognosis. Adjuvant RT after LUMP significantly improves survival of patients with PSCC of the breast. Further studies are still needed to investigate the role of adjuvant RT in PSCC of the breast after mastectomy.

A Case of Primary Squamous Cell Carcinoma of The Thyroid Gland

Primary squamous cell carcinoma of thyroid is a very rare malignant tumor with poor prognosis. It is usually diagnosed as an advanced disease infiltrating adjacent organs, and characterized by aggressive clinical course with an average postoperative survival time of less than 1 year. Recently, we had a 79- year-old woman with a painful neck mass who was diagnosed as primary squamous cell carcinoma of thyroid gland. She underwent total thyroidectomy and selective neck dissection(level Ⅲ, Ⅵ) with no further postoperative managements such as radiation therapy or chemotherapy; she died of poor general condition and pneumonia resulting from rapid progression of the lesion on the 38th day after surgery. We report this case with a review of relevant literatures.

Management of Primary Squamous Cell Carcinoma of the Pancreas: A Case Report

Introduction: Primary squamous cell carcinoma of the pancreas (SCCP) is a rare malignant tumor that has been reported in individual case reports only. The clinical data on primary SCCP treatment are limited. Therefore, the appropriate management strategy for this disease should be standardized.Case Presentation: We present the case of a 63-year-old man admitted to our hospital for upper left abdominal pain for 2 months without weight loss or jaundice. Enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen revealed a mixed solid and cystic lesion in the pancreatic tail, measuring 35 × 37 mm in maximum diameter with enhancement. The patient was diagnosed with primary SCCP without metastasis, based on radiological and pathological findings. He did not receive neoadjuvant therapy postoperatively and was followed up by CT and MRI for 18 months without recurrence or metastasis.Result: Complete resection is the most effective treatment for early stage primary SCCP. Abdominal MRI is an effective imaging tool for preoperative evaluation and postoperative follow-up of primary SCCP. The need for neoadjuvant therapy depends on various factors.Conclusion: Primary SCCP is a tumor with poor prognosis. Risk factor control, early accurate radiologic evaluation, and individualized treatment strategies improve the quality of life and prolong the overall survival period of patients.

Enlightenment for Clinicians From the Case of Digestive Tract Metastases From Primary Lung Cancer: a Case Report

Background: About 50% of patients with initially diagnosed lung cancer have developed distant metastasis. The probability of occurrence of digestive tract metastases found by autopsy is rarely. This report presents a rare clinical case of small intestinal metastasis from primary squamous cell carcinoma of the lung. Case presentation: An 82-year-old male with aggravated cough and more acute shortness of breath than usual was diagnosed with primary squamous cell carcinoma of the lung Stage IV, because of the advanced age, underlying diseases, and poor cardiopulmonary function,the family refused the chemoradiotherapy.One month later, the patient gradually developed right lower quadrant pain. An upright abdominal X-ray suggested small intestinal obstruction and partial resection and anastomosis of the small intestine were performed. Postoperative pathology revealed poorly differentiated squamous-cell carcinoma of the small intestine. The patient died of sudden cardio-respiratory arrest one month later. Conclusions: We conclude that the real incidence of digestive tract metastases from lung cancer may be higher than the reported because of the symptoms of those patients are not obvious. Clinicians should select the appropriate examination methods (such as positron emission tomography) and pay attention to the assessment of abdominal hollow organs.

Primary squamous cell carcinoma of renal pelvis and kidney- Sole diagnosis by histopathology

Primary Squamous cell carcinoma of the renal pelvis is rare and accounts to only 0.5- 0.8 % of malignant renal tumours having poor prognosis. Chronic irritation, inflammation and infection induce the pathogenesis of this malignancy. A 53 year old male patient, presented with left flank pain since one month. On radiological investigation, his CT revealed atrophic shrunken left kidney measuring 7.9x5.2cms showing significant parenchymal thinning and complete loss of corticomedullary differentiation. A left upper ureteric calculus is seen measuring 7.5 mm with significant left renal hydronephrosis.Clinically, it was diagnosed as Xanthogranulomatous Pyelonephritis. Grossly the radical nephrectomy specimen measures 10.5x5.5x3.5cm. External surface is irregular & bosselated. On Cut surface renal architecture is effaced by necrotic mass measuring 9.5x5.0x3.0 cm involving pelvic ureter and most of renal parenchyma.Hematoxylin and eosin stained tissue revealed characteristic feature such as keratin pearls and intracellular bridges seen, rendering the diagnosis of well-differentiated keratinising squmaous cell carcinoma seen with 40% tumour necrosis associated with Keratinizing Squamous Dysplasia. In the present case, obstructive uropathy has triggered the event of malignancy. The radiologic differential diagnosis includes primary and secondary renal neoplasms and xanthogranulomatous pyelonephritis associated with renal calculi. XGP is commonly associated with lithiasis however, rarely causes keratinizing squamous metaplasia and its manifestations closely mimic renal neoplasm, leading to misdiagnosis of malignancy.The prognosis is dismal with a 5-year survival rate of &#60;10%. CT and MRI play a crucial role in diagnosis and staging of these tumors, though histology always remains confirmatory and diagnostic.