Metastatic squamous cell carcinoma of the pleura

A rare complication of hidradenitis suppurativa

Kiran Joglekar, Christopher Jackson, Dipen Kadaria, Amik Sodhi

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: Rare disease Background: Squamous cell carcinoma (SCC), also known as Marjolin ulcer, is a rare complication of hidradenitis suppurativa (HS). Metastatic SCC from HS typically involves the axial skeleton or abdominopelvic viscera. Metastatic disease to the lungs is a rare phenomenon with only three reported cases of lung parenchyma. We present a biopsy proven case of metastatic SCC to the pleura from gluteal HS. Case Report: A 46-year-old male with a history of recently diagnosed Marjolin ulcer secondary to gluteal HS was transferred to our intensive care unit for acute hypoxemic respiratory failure secondary to recurrent pleural effusion. On examination, patient was febrile (38.3°C), normotensive (blood pressure 98/65 mm Hg), tachycardic (116 beats/minute) and tachypneic (40 breaths/minute) with oxygen saturation of 93% on room air. He was in moderate distress requiring endotracheal intubation and mechanical ventilation. Chest examination revealed decreased breath sounds bilaterally and skin examination was significant for 18 cm wide sacral lesion. CT thorax showed bilateral pleural effusions, pleural thickening, and scattered nodular densities within both lungs concerning for metastatic disease. Thoracentesis showed lymphocyte predominant exudate with negative cytology for malignant cells. A video-assisted thoracoscopic surgery (VATS) illustrated thickened pleural rind with histopathology and positive p40 stain consistent with invasive well-to-moderately differentiated keratinizing SCC. Conclusions: SCC arising from HS is rare and metastatic disease to the pleura has not been reported previously. Strong clinical suspicion for malignancy is warranted in patients with advanced HS and evolving pulmonary symptoms despite negative cytology.

Original languageEnglish (US)
Pages (from-to)989-992
Number of pages4
JournalAmerican Journal of Case Reports
Volume17
DOIs
StatePublished - Dec 28 2016

Fingerprint

Hidradenitis Suppurativa
Pleura
Squamous Cell Carcinoma
Pleural Effusion
Rare Diseases
Lung
Ulcer
Cell Biology
Thorax
Video-Assisted Thoracic Surgery
Intratracheal Intubation
Viscera
Exudates and Transudates
Artificial Respiration
Skeleton
Respiratory Insufficiency
Lung Diseases
Intensive Care Units
Fever
Coloring Agents

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Metastatic squamous cell carcinoma of the pleura : A rare complication of hidradenitis suppurativa. / Joglekar, Kiran; Jackson, Christopher; Kadaria, Dipen; Sodhi, Amik.

In: American Journal of Case Reports, Vol. 17, 28.12.2016, p. 989-992.

Research output: Contribution to journalArticle

@article{89499108dad2475a84f452569e010c16,
title = "Metastatic squamous cell carcinoma of the pleura: A rare complication of hidradenitis suppurativa",
abstract = "Objective: Rare disease Background: Squamous cell carcinoma (SCC), also known as Marjolin ulcer, is a rare complication of hidradenitis suppurativa (HS). Metastatic SCC from HS typically involves the axial skeleton or abdominopelvic viscera. Metastatic disease to the lungs is a rare phenomenon with only three reported cases of lung parenchyma. We present a biopsy proven case of metastatic SCC to the pleura from gluteal HS. Case Report: A 46-year-old male with a history of recently diagnosed Marjolin ulcer secondary to gluteal HS was transferred to our intensive care unit for acute hypoxemic respiratory failure secondary to recurrent pleural effusion. On examination, patient was febrile (38.3°C), normotensive (blood pressure 98/65 mm Hg), tachycardic (116 beats/minute) and tachypneic (40 breaths/minute) with oxygen saturation of 93{\%} on room air. He was in moderate distress requiring endotracheal intubation and mechanical ventilation. Chest examination revealed decreased breath sounds bilaterally and skin examination was significant for 18 cm wide sacral lesion. CT thorax showed bilateral pleural effusions, pleural thickening, and scattered nodular densities within both lungs concerning for metastatic disease. Thoracentesis showed lymphocyte predominant exudate with negative cytology for malignant cells. A video-assisted thoracoscopic surgery (VATS) illustrated thickened pleural rind with histopathology and positive p40 stain consistent with invasive well-to-moderately differentiated keratinizing SCC. Conclusions: SCC arising from HS is rare and metastatic disease to the pleura has not been reported previously. Strong clinical suspicion for malignancy is warranted in patients with advanced HS and evolving pulmonary symptoms despite negative cytology.",
author = "Kiran Joglekar and Christopher Jackson and Dipen Kadaria and Amik Sodhi",
year = "2016",
month = "12",
day = "28",
doi = "10.12659/AJCR.900829",
language = "English (US)",
volume = "17",
pages = "989--992",
journal = "American Journal of Case Reports",
issn = "1941-5923",
publisher = "International Scientific Literature, Inc",

}

TY - JOUR

T1 - Metastatic squamous cell carcinoma of the pleura

T2 - A rare complication of hidradenitis suppurativa

AU - Joglekar, Kiran

AU - Jackson, Christopher

AU - Kadaria, Dipen

AU - Sodhi, Amik

PY - 2016/12/28

Y1 - 2016/12/28

N2 - Objective: Rare disease Background: Squamous cell carcinoma (SCC), also known as Marjolin ulcer, is a rare complication of hidradenitis suppurativa (HS). Metastatic SCC from HS typically involves the axial skeleton or abdominopelvic viscera. Metastatic disease to the lungs is a rare phenomenon with only three reported cases of lung parenchyma. We present a biopsy proven case of metastatic SCC to the pleura from gluteal HS. Case Report: A 46-year-old male with a history of recently diagnosed Marjolin ulcer secondary to gluteal HS was transferred to our intensive care unit for acute hypoxemic respiratory failure secondary to recurrent pleural effusion. On examination, patient was febrile (38.3°C), normotensive (blood pressure 98/65 mm Hg), tachycardic (116 beats/minute) and tachypneic (40 breaths/minute) with oxygen saturation of 93% on room air. He was in moderate distress requiring endotracheal intubation and mechanical ventilation. Chest examination revealed decreased breath sounds bilaterally and skin examination was significant for 18 cm wide sacral lesion. CT thorax showed bilateral pleural effusions, pleural thickening, and scattered nodular densities within both lungs concerning for metastatic disease. Thoracentesis showed lymphocyte predominant exudate with negative cytology for malignant cells. A video-assisted thoracoscopic surgery (VATS) illustrated thickened pleural rind with histopathology and positive p40 stain consistent with invasive well-to-moderately differentiated keratinizing SCC. Conclusions: SCC arising from HS is rare and metastatic disease to the pleura has not been reported previously. Strong clinical suspicion for malignancy is warranted in patients with advanced HS and evolving pulmonary symptoms despite negative cytology.

AB - Objective: Rare disease Background: Squamous cell carcinoma (SCC), also known as Marjolin ulcer, is a rare complication of hidradenitis suppurativa (HS). Metastatic SCC from HS typically involves the axial skeleton or abdominopelvic viscera. Metastatic disease to the lungs is a rare phenomenon with only three reported cases of lung parenchyma. We present a biopsy proven case of metastatic SCC to the pleura from gluteal HS. Case Report: A 46-year-old male with a history of recently diagnosed Marjolin ulcer secondary to gluteal HS was transferred to our intensive care unit for acute hypoxemic respiratory failure secondary to recurrent pleural effusion. On examination, patient was febrile (38.3°C), normotensive (blood pressure 98/65 mm Hg), tachycardic (116 beats/minute) and tachypneic (40 breaths/minute) with oxygen saturation of 93% on room air. He was in moderate distress requiring endotracheal intubation and mechanical ventilation. Chest examination revealed decreased breath sounds bilaterally and skin examination was significant for 18 cm wide sacral lesion. CT thorax showed bilateral pleural effusions, pleural thickening, and scattered nodular densities within both lungs concerning for metastatic disease. Thoracentesis showed lymphocyte predominant exudate with negative cytology for malignant cells. A video-assisted thoracoscopic surgery (VATS) illustrated thickened pleural rind with histopathology and positive p40 stain consistent with invasive well-to-moderately differentiated keratinizing SCC. Conclusions: SCC arising from HS is rare and metastatic disease to the pleura has not been reported previously. Strong clinical suspicion for malignancy is warranted in patients with advanced HS and evolving pulmonary symptoms despite negative cytology.

UR - http://www.scopus.com/inward/record.url?scp=85008324916&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85008324916&partnerID=8YFLogxK

U2 - 10.12659/AJCR.900829

DO - 10.12659/AJCR.900829

M3 - Article

VL - 17

SP - 989

EP - 992

JO - American Journal of Case Reports

JF - American Journal of Case Reports

SN - 1941-5923

ER -