P2.04-043 Squamous Cell Carcinoma Arising from the Pleura. An Interesting Case Report: Topic: Esophageal Cancer and Other Malignancies

Abstract

Squamous pleura carcinoma is a very rare entity with sporadic literature reports. Literature research reveals 12 reports of squamous carcinoma arising from pleura in patients with chronically draining empyema/ locally deteriorated inflammation. We state an unusual interesting case report of primary squamous pleura carcinoma and present relevant literature surveillance. The patient, 48 years old, male, heavy smoker, reported constant right chest pain and experienced dyspnea recently started His chest X ray revealed pleural effusion and mesothelioma infiltration was suspected. Endoscopy revealed no abnormalities. Subsequent Ct scan showed a 4cm mass arising from pleura and a computed tomography scan revealed an expanded mass in the right thoracic cavity, involving the surrounding tissue. He underwent needle biopsy ultrasound guided. The macroscopic pathologic findings demonstrated a grayish-white mass with hemorrhage beneath the pleura. They revealed multifocal, poor-differentiated, squamous cell carcinoma with histology that was distinctly different from that of original lung cancer arise and consistent with pleura (p63+, CK5/6 +, p40+, TTF/1-). He received 1rst line chemotherapy treatment with platinum based combination with taxane and the patient had an excellent response with no effusion production and rapid thoracic pain and dyspnea relief. He is still in excellent status post 6 cycles chemotherapy, with no evidence of disease deterioration. The final scope of surgical total resection is being considered. Cases of squamous cell carcinoma arising from pleura in patients with a chronically draining empyema or inflammation cavity are rare. The documented in literature review chemotherapy combinations are of limited expectations and no complete response is reported when rare reports are documented. We suggest a thorough pathologic study when pleura masses are found to exclude the common mesothelioma diagnoses since seldom entities as pleura cancers need an individualized therapeutic manipulation.