VA Caribbean Healthcare System San Juan, PR, United States
Orlando Rodriguez-Amador, MD, Jeremy Feliciano-Ildefonso, MD, Zeyn Mirza, MD, Loscar Santiago-Rivera, MD, FACG VA Caribbean Healthcare System, San Juan, Puerto Rico
Introduction: Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive subtype of squamous cell carcinoma with a strong preference for the larynx, hypopharynx, oropharynx and oral cavity. It has a high degree of metastasis to the brain, bone, lung, liver, dura and the cervical lymph nodes. Diagnosis is made with histological findings of both basaloid and squamous cell components, with a predominating basaloid component. On presentation, patient often shows with advance disease and the survival rate is poorer in comparison with conventional SCC. Treatment consists of complete surgical excision, radiotherapy or chemotherapy depending on the patient’s specific condition. Here we present a case of basaloid squamous cell carcinoma with liver metastasis.
Case Description/Methods: A 69 year old male with medical history of chronic liver disease due to alcohol cirrhosis and Hepatitis C (treatment naïve), left pharyngeal/tonsillar HPV+ squamous cell carcinoma s/p radiotherapy plus Cetuximab who had follow-up PET-CT after completion of therapy with findings of hypermetabolic lesion on rectosigmoid junction area consulted for sigmoidoscopy. PET-CT also with evidence of multiple hypermetabolic lesions throughout the liver. On day of intervention patient was
found with grade II ascites. Admitted with acute over chronic decompensated liver disease with suspected malignancy progression. Liver biopsy performed and results came back positive for metastatic basaloid squamous cell carcinoma to the liver (CK5/6 positive). Patient opted for hospice care.
Discussion: BSSC is a rare variant of squamous cell carcinoma with a frequency of < 1% of all squamous cell carcinoma and more common in older men. It presents with high grade of metastasis with one of the target organs being the liver. There are limited case reports of BSCC with liver metastasis on the available literature. Here we presented a case of relapse of the disease with high grade metastasis presenting as decompensated CLD. The importance of our case is to add to the limited number of cases available about this aggressive cancer to current literature. With this, we hope to raise awareness of this rare type of SCCits aggressiveness, and how it may present with symptoms of liver decompensation. In view that in most cases it may present as stage III to IV, the overall survival rate and patient prognosis is unfavorable.
Orlando Rodriguez-Amador indicated no relevant financial relationships.
Jeremy Feliciano-Ildefonso indicated no relevant financial relationships.
Zeyn Mirza indicated no relevant financial relationships.
Loscar Santiago-Rivera indicated no relevant financial relationships.
Orlando Rodriguez-Amador, MD, Jeremy Feliciano-Ildefonso, MD, Zeyn Mirza, MD, Loscar Santiago-Rivera, MD, FACG. P0799 - Hurry Up and Treat, a Deadly Variant: Metastatic Basaloid Squamous Cell Carcinoma, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.