Nuances in Treating Squamous Cell Lung Cancer: Case 1

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Nuances in Treating Squamous Cell Lung Cancer

April 2013

  • A 72-year-old female presented to her primary care physician with symptoms of shortness of breath and increased cough.
  • The patient has a 40-year (1 pack/day) smoking history.
  • Chest X-Ray revealed a right upper lobe opacity.
  • CT of the chest and abdomen showed a 3 cm. right upper lobe mass, pleural thickening, and a left adrenal gland nodule.
  • She underwent core needle biopsy, the left adrenal mass showed squamous cell carcinoma that was p40+ and p63+.
  • PET/CT indicated stage IV squamous cell lung cancer.
  • The patient began chemotherapy with carboplatin/nab-paclitaxel.
  • CT after 2 cycles of therapy indicated that her tumor burden decreased significantly. At that point the patient reported improvement of her symptoms.
  • After 6 cycles the patient had stable disease.

October 2015

  • Routine follow up imaging showed a new left upper lobe mass of 2 cm.
  • The lung lesion was biopsied and confirmed to be of squamous cell histology.
  • Based on multidisciplinary assessment, the new lung lesion was treated with stereotactic radiosurgery.

June 2016

  • The patient reported symptoms of coughing and shortness of breath.
  • CT showed increased diameter in both lung masses. The adrenal mass remained stable.
  • The patient was subsequently started on nivolumab.
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