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Squamous Cell Carcinoma in a Young Patient with a Chronic Infectious Disease
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A4020 - Squamous Cell Carcinoma in a Young Patient with a Chronic Infectious Disease
Author Block: M. Dianti, A. Casey, E. A. Vallejos, G. F. Ferreyra, H. Iannella, R. Berenguer, P. Vujacich; Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
Lung cancer in young patients is quite uncommon, with reports of only 0.4% of all lung cancers in patients under 30 years of age. We present the case of a young patient with an unsuspected diagnosis. A 28 year old white female presents to the emergency room with dyspnea, cough and fever. She had experienced these symptoms recurrently over the past months, receiving oral and intravenous antibiotics on more than one opportunity. She also complained of right hypochondriac pain. She had smoked during two years. She revealed a history of recurrent respiratory pappilomatosis (RRP). Diagnosed at 2 years of age, infected during childbirth, she received interferon at age of 5. Upon follow up, she developed recurrent laryngeal pappilomas and underwent multiple endoscopic resections. In 2015, a lung CT scan revealed multiple bilateral cavities and a mass in the periphery of the lower left lobe (LLL). A biopsy of that lesion revealed pappilomatosis. At that time, viral serotyping was not available. She became pregnant and lost follow up. Upon arrival, CT scan showed a central heterogeneous mass in the LLL, no other lesion in the rest of the parenchyma, and an hypondense mass in the liver. Flexible bronchoscopy informed two small pappilomas in the vocal cords and a friable occlusive intraluminal exophytic lesion in the inferior lobar bronchus. A bronchial lavage was made at the site for microbiologic and pathology analyses. The patient was referred for endoscopic surgical removal of the lesion. She also underwent hepatic fine needle aspiration biopsy. Pathologic analyses from the bronchial lavage was compatible with squamous cell carcinoma, and the liver biopsy with metastasis of squamous carcinoma. RRP is a rare chronic disease caused by HPV, characterized by recurrent growth of papillomas in the aerodigestive tract; is the most common benign neoplastic disease of the larynx in children and adolescents. The course of the disease is unpredictable; spontaneous remission is possible. Although pulmonary spread and malignant transformation have been reported, they are rare. We think that close follow up of patients with this condition is important.
Author Block: M. Dianti, A. Casey, E. A. Vallejos, G. F. Ferreyra, H. Iannella, R. Berenguer, P. Vujacich; Hospital de Clínicas José de San Martín, Buenos Aires, Argentina.
Lung cancer in young patients is quite uncommon, with reports of only 0.4% of all lung cancers in patients under 30 years of age. We present the case of a young patient with an unsuspected diagnosis. A 28 year old white female presents to the emergency room with dyspnea, cough and fever. She had experienced these symptoms recurrently over the past months, receiving oral and intravenous antibiotics on more than one opportunity. She also complained of right hypochondriac pain. She had smoked during two years. She revealed a history of recurrent respiratory pappilomatosis (RRP). Diagnosed at 2 years of age, infected during childbirth, she received interferon at age of 5. Upon follow up, she developed recurrent laryngeal pappilomas and underwent multiple endoscopic resections. In 2015, a lung CT scan revealed multiple bilateral cavities and a mass in the periphery of the lower left lobe (LLL). A biopsy of that lesion revealed pappilomatosis. At that time, viral serotyping was not available. She became pregnant and lost follow up. Upon arrival, CT scan showed a central heterogeneous mass in the LLL, no other lesion in the rest of the parenchyma, and an hypondense mass in the liver. Flexible bronchoscopy informed two small pappilomas in the vocal cords and a friable occlusive intraluminal exophytic lesion in the inferior lobar bronchus. A bronchial lavage was made at the site for microbiologic and pathology analyses. The patient was referred for endoscopic surgical removal of the lesion. She also underwent hepatic fine needle aspiration biopsy. Pathologic analyses from the bronchial lavage was compatible with squamous cell carcinoma, and the liver biopsy with metastasis of squamous carcinoma. RRP is a rare chronic disease caused by HPV, characterized by recurrent growth of papillomas in the aerodigestive tract; is the most common benign neoplastic disease of the larynx in children and adolescents. The course of the disease is unpredictable; spontaneous remission is possible. Although pulmonary spread and malignant transformation have been reported, they are rare. We think that close follow up of patients with this condition is important.
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