Gohar Ali, Ahmed Bilal, Mohammad Ozaire, Ali Masab, Ahmad Muhammad Husnain, Iqbal Aqsa, Zaitoon Summaya, Ashraf Saad
Department of Internal Medicine, Lahore General Hospital, Lahore, Punjab, Pakistan.
Department of Pulmonology, Pneumology Clinic, Paris Metropolitan Area, France.
Ann Med Surg (Lond). 2025 Mar 7;87(6):3837-3841. doi: 10.1097/MS9.0000000000003148. eCollection 2025 Jun.
Basaloid squamous cell carcinoma (BSQCC) of the lung is a rare and aggressive subtype of squamous cell carcinoma. It predominantly affects individuals over 60 with a history of tobacco use. This case report highlights the unique presentation of BSQCC in a young, non-smoking patient, emphasizing the need for early and accurate diagnosis.
A 32-year-old male presented with a 1-month history of productive cough and dyspnea. Imaging revealed a right middle lobe mass with bronchial wall thickening. Immunohistochemistry confirmed BSQCC (p63 positive, TTF-1 negative). Molecular analysis identified a TP53 mutation and ZMYND8::FOXO1 transcription, which has not been previously described in BSQCC. Despite chemotherapy with carboplatin-paclitaxel followed by a second-line regimen, rapid disease progression ensued, leading to pleural effusion, cardiac tamponade, and fatal cardiac arrest within 2 months.
This case highlights diagnostic challenges posed by BSQCC, particularly in atypical presentations without standard risk factors. Molecular findings suggest genetic diversity in BSQCC and underscore the potential for novel markers in diagnosis and prognosis. The advanced stage and rapid progression in this patient limited treatment options, demonstrating the critical need for early molecular testing and multidisciplinary care.
BSQCC is an aggressive carcinoma requiring prompt diagnosis and treatment. This case underscores the importance of heightened awareness, molecular profiling, and further research to improve outcomes in rare lung cancers.
肺基底样鳞状细胞癌（BSQCC）是鳞状细胞癌中一种罕见且侵袭性强的亚型。它主要影响60岁以上有吸烟史的个体。本病例报告强调了BSQCC在一名年轻非吸烟患者中的独特表现，强调了早期准确诊断的必要性。
一名32岁男性，有1个月的咳痰和呼吸困难病史。影像学检查发现右中叶肿块伴支气管壁增厚。免疫组化证实为BSQCC（p63阳性，TTF-1阴性）。分子分析发现了TP53突变和ZMYND8::FOXO1转录，这在BSQCC中此前未曾有过描述。尽管接受了卡铂-紫杉醇化疗，随后采用二线治疗方案，但疾病仍迅速进展，在2个月内导致胸腔积液、心脏压塞和致命性心脏骤停。
本病例突出了BSQCC带来的诊断挑战，尤其是在没有标准危险因素的非典型表现中。分子研究结果表明BSQCC存在基因多样性，并强调了新型标志物在诊断和预后方面的潜力。该患者的晚期阶段和快速进展限制了治疗选择，表明迫切需要早期分子检测和多学科治疗。
BSQCC是一种侵袭性癌，需要及时诊断和治疗。本病例强调了提高认识、分子分析以及进一步研究以改善罕见肺癌治疗效果的重要性。
