Pseudomesotheliomatous Primary Squamous Cell Lung Carcinoma: The First Case Reported in Turkey and a Review of the Literature

Our plain-English summary of Pseudomesotheliomatous Primary Squamous Cell Lung Carcinoma: The First Case Reported in Turkey and a Review of the Literature, by N. Katgi, M. Unlu, P. Cimen, et al (Open Medicine, 2018).

The study

• Authors: N. Katgi, M. Unlu, P. Cimen, E. Oner, B. Serez, D. Giakoup
• Journal: Open Medicine
• Published: 2018;13:324-328
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

In rare cases, pseudomesotheliomatous tumors spread diffusely within the pleura to form an encasing mass, which may be confused with diffuse malignant mesothelioma (DMM). A 73-year-old male presented with chest pain, dyspnea and a significant loss of weight and appetite. His radiological and clinical features suggested DMM. However, immunohistochemical studies revealed a primary squamous cell cancer of the lung. To the best of our knowledge, this is the first case report of pseudomesotheliomatous primary squamous cell lung cancer in Turkey, and also the seventh case worldwide. The present report aims to present this case, along with a review of the medical literature.

In plain English

This article was a case report with a short review of previously published cases. It described a 73-year-old man in Turkey who had worked as a farmer for about fifty years, had smoked 75 pack-years, and had no known history of asbestos exposure. He came to hospital with loss of appetite and weight, chest pain and shortness of breath. His scans showed fluid, thickening and nodules in the lining of the left chest, and his clinical and radiological features suggested diffuse malignant mesothelioma. A CT-guided tru-cut biopsy of the thickened areas instead showed squamous cell carcinoma of the lung. The tumor cells stained only for the marker p63, not for TTF-1, vimentin or calretinin. After six cycles of chemotherapy he showed a nearly complete response. He later developed bone and then brain metastases and died. He survived about 9 months after diagnosis. In their review, the authors found only six earlier reported cases of this tumor type worldwide and none in Turkey. They stressed the need for advanced immunohistochemical tests to tell such tumors apart from mesothelioma.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: case report with a literature review
• Who was studied: one 73-year-old man treated at a hospital in Turkey, who had loss of appetite and weight, chest pain and shortness of breath for two months
• Exposure: no known asbestos exposure; the patient had worked as a farmer for about fifty years and had a 75 pack-year smoking history
• Main results:
  • The patient's radiological and clinical features suggested diffuse malignant mesothelioma (DMM); CT showed pleural fluid, pleural thickening and pleural nodules in the left chest.
  • A CT-guided tru-cut biopsy of the pleural thickening led to a diagnosis of squamous cell carcinoma of the lung.
  • The tumor cells expressed only p63; they did not express TTF-1 and did not stain with vimentin or calretinin.
  • After six cycles of cisplatin and docetaxel chemotherapy, the patient showed a nearly complete response.
  • About four months after the last chemotherapy course, the patient developed bone metastases. Later he developed brain metastases and died about two days after they were found.
  • The patient survived about 9 months after diagnosis.
  • In the authors' literature review, pseudomesotheliomatous squamous cell lung carcinoma had been reported in only six cases worldwide and in none in Turkey.
• The authors' conclusion: The authors concluded that pseudomesotheliomatous primary squamous cell lung carcinoma is an extremely rare tumor that can mimic DMM clinically and radiologically. They emphasised the need for advanced immunohistochemical methods to distinguish the two.
• Limitations the authors state:
  • The authors could not obtain clear information on patient survival from the earlier articles they reviewed.

Topics

Medical terms in this study, explained in our Lexicon: Squamous Cell Carcinoma, Carcinoma, Pleura, Mesothelioma, Dyspnea, Lung Cancer.

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