Squamous cell carcinoma of the lung is one of the most common subtypes of lung cancers and belongs to the group of non-small cell lung carcinomas. Cigarette smoking is still recognized as the principal risk factor. Patients may be completely asymptomatic or present with dyspnea, cough, hemoptysis, weight loss, and an array of paraneoplastic syndromes. Imaging studies and a biopsy of the tumor are essential to identify the location, the extent of tumor progression, and the exact type.
Presentation
Lung cancer is the most important malignancy-related death worldwide, causing more than 150,000 deaths in the United States alone every year [1]. Two broad categories exist - small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC), with approximately 85% of new cases being NSCLC [2] [3] [4]. Squamous cell carcinoma of the lung (estimated to cause 400,000 deaths worldwide every year) comprises approximately 30% of all NSCLC cases [2] [5] [6] [7]. Similarly to other subtypes, tobacco smoking remains the single most important risk factor for its development, while exposure to radon gas and asbestos are well-known risk factors as well [2] [5] [6] [7]. The clinical presentation of lung cancer is highly variable. The diagnosis is made incidentally in a significant number of patients, as many are asymptomatic when lung cancer is detected [4] [8]. Conversely, the progression of the tumor and several other factors (eg. location) may lead to symptoms such as dyspnea, chest pain, hemoptysis, weight loss, fatigue, and anorexia [3] [4] [8] [9]. Numerous complications are documented, including pleural effusions, thromboembolic disease, together with several paraneoplastic syndromes that have been described [4] [8] [9]. Additionally, metastatic spread to various sites can produce characteristic symptoms - localized pain and fractures are seen with skeletal metastases; headaches, nausea, vomiting, and mental changes are main signs of cranial spread, whereas lymphadenopathy, hepatomegaly, and subcutaneous nodules are other notable findings [8]. Given the limited choices of therapy for squamous cell carcinoma of the lung the prognosis remains poor, particularly in the case of metastatic spread [7].
Entire Body System
- Anorexia
Three of five patients (60%) experienced grade 3 or more toxicities (dyspnea, fatigue, elevated level of aspartate transaminase, anorexia, nausea). Intolerable grade 2 pleural effusions were noted in two of five patients. [ncbi.nlm.nih.gov]
Conversely, the progression of the tumor and several other factors (eg. location) may lead to symptoms such as dyspnea, chest pain, hemoptysis, weight loss, fatigue, and anorexia. [symptoma.com]
- Severe Pain
Central tumours generally produce symptoms of cough, dyspnea, atelectasis, postobstructive pneumonia, wheezing, and hemoptysis; whereas, peripheral tumours, in addition to causing cough and dyspnea, can lead to pleural effusion and severe pain as a result [pathophys.org]
Complications of NSCLC Spinal cord compression Bone pain Hormone or electrolyte imbalances Problems with mental functioning or concentration Visual problems Liver failure Pain in right side from enlarged liver Weight loss Severe hemoptysis (coughing up [emedicinehealth.com]
Respiratoric
- Pneumonia
The metastatic lesions consisted largely of acantholytic tumor cells, and the lungs showed usual interstitial pneumonia pattern; vasculitis was absent. [ncbi.nlm.nih.gov]
Since squamous cell carcinoma usually occurs near the bronchi, the tumor can cause cough (sometimes a cough that is tinged with blood), shortness of breath, wheezing, and pneumonia in the area between the tumor and the edge of the lung. [lung-cancer.com]
Fatal adverse reactions in GILOTRIF-treated patients included pulmonary toxicity/ILD-like adverse reactions (1.3%), sepsis (0.43%), and pneumonia (0.43%). [boehringer-ingelheim.us]
- Hemoptysis
Patients may be completely asymptomatic or present with dyspnea, cough, hemoptysis, weight loss, and an array of paraneoplastic syndromes. [symptoma.com]
Snap Shot A 69-year-old male with a 50-pack-year smoking history presents with worsening cough, weight loss, and repeated episodes of hemoptysis. A chest radiograph is taken and shown at right. [medbullets.com]
He had an esophageal stent inserted, but he later died of sudden hemoptysis. © 2017 The Author(s). Published by S. [karger.com]
[…] comorbidities, including low pulmonary reserve and presence of COPD. 3,4 Additionally, SqCC often involves the central airways, and the location of these tumors in proximity to large blood vessels can present treatment challenges, including bleeding and hemoptysis [targetedonc.com]
Clinical: May be associated with elevated serum calcium. [1] +/-Hemoptysis. Gross Lung mass - usually centrally located, i.e. associated with a large airway. Image Squamous carcinoma of the lung. (WC) Microscopic Features: Central nucleus. [librepathology.org]
- Sputum
A 75-year-old Japanese male visited a local hospital complaining cough and bloody sputum. A chest plain radiograph and computed tomographic (CT) scans of the chest demonstrated a right hilar mass. [ncbi.nlm.nih.gov]
There are a number of ways of obtaining samples of suspected cancer cells: Sputum cytology: cells from the sputum (spit) are examined for signs of malignancy (cancer). [myvmc.com]
Abstract A 73-year-old man was referred to our hospital after a 2-week history of bloody sputum and cough. [karger.com]
[…] risk factors are type specific (see below) Presentation symptoms cough dyspnea hemoptysis physical exam bronchial obstruction wheezing weight loss Evaluation imaging chest radiograph "coin" lesion important to compare to previous films if available CT sputum [medbullets.com]
A PET scan is also helpful in detecting recurrences, or if any metastasis (to the surrounding lymph nodes of the lungs) has occurred Sputum cytology: Sputum cytology is test that involves the collection of mucus (sputum), coughed-up by a patient. [dovemed.com]
- Hoarseness
[…] films if available CT sputum cytology fine-needle aspiration (FNA) bronchoscopy +/- lavage Differential diagnosis hamartomas granulomatous disease e.g. histoplasmosis and tuberculosis Complications superior vena cava syndrome paraneoplastic syndromes hoarseness [medbullets.com]
These are some of the most common symptoms of lung cancer: persistent or worsening cough wheezing coughing up blood and mucus chest pain that gets worse when you take a deep breath, laugh, or cough shortness of breath hoarseness weakness, fatigue frequent [healthline.com]
Signs and symptoms of lung cancer may include: A new cough that doesn't go away Coughing up blood, even a small amount Shortness of breath Chest pain Hoarseness Losing weight without trying Bone pain Headache When to see a doctor Make an appointment with [mayoclinic.org]
Symptoms of Non-Small Cell Lung Cancer Symptoms of non-small cell lung cancer include a persistent cough that worsens over time, continual chest pains, coughing up or expectorating blood, shortness of breath, hoarseness, tightening in the chest, recurring [impactlaw.com]
Like other types of lung cancer, symptoms can include: Coughing that lasts or gets worse Chest pain that often hurts more when you cough, laugh, or take deep breaths Hoarseness or voice changes Harsh, raspy sounds when you breathe Wheezing Weight loss [webmd.com]
- Painful Cough
Symptoms Pleural Mesothelioma Symptoms of pleural mesothelioma cancer include shortness of breath, chest pain, a persistent cough, loss of appetite, fatigue, accumulation of pleural fluid (which causes chest pain), and weight loss. [impactlaw.com]
Lung cancer at an early stage may not cause any symptoms but when the tumor has grown, it may manifest itself by the following signs and symptoms: cough chest pain coughing out of blood chest infection malaise poor appetite and weight loss shortness of [lcp.gov.ph]
If you have symptoms of lung cancer, they may include: A cough that does not go away and gets worse over time Constant chest pain, often made worse by deep breathing, coughing or laughing Arm or shoulder pain Coughing up blood or rust-colored phlegm Shortness [mdanderson.org]
Gastrointestinal
- Dysphagia
Dysphagia (difficulty swallowing, solids worse than liquids) and painful swallowing are common initial symptoms. If the disease is localized, surgical removal of the affected esophagus may offer the possibility of a cure. [en.wikipedia.org]
Oncologic emergencies chapter Pleural effusion Chest pain Dyspnea Benign pleural effusion may be due to lymphatic obstruction, post-obstructive pneumonitis, or atelectasis Malignant pleural effusion occurs when malignant cells are present in pleural fluid Dysphagia [pathophys.org]
Symptoms may result from local invasion or compression of adjacent thoracic structures such as compression involving the esophagus causing dysphagia, compression involving the laryngeal nerves causing hoarseness, or compression involving the superior [cancer.gov]
Cardiovascular
- Chest Pain
He received palliative treatment but died 4 months after the onset of chest pain. [ncbi.nlm.nih.gov]
Symptoms Pleural Mesothelioma Symptoms of pleural mesothelioma cancer include shortness of breath, chest pain, a persistent cough, loss of appetite, fatigue, accumulation of pleural fluid (which causes chest pain), and weight loss. [impactlaw.com]
Conversely, the progression of the tumor and several other factors (eg. location) may lead to symptoms such as dyspnea, chest pain, hemoptysis, weight loss, fatigue, and anorexia. [symptoma.com]
See also Mediastinal involvement Chest pain (20%) Tumour involving pleural surface causing pleuritic chest pain See also Mediastinal involvement Mediastinal involvement Superior vena cava syndrome Obstruction of superior vena cava by the tumour More common [pathophys.org]
These include worsening cough, including hemoptysis, chest pain, shortness of breath and weight loss. [en.wikipedia.org]
Musculoskeletal
- Neck Pain
Symptoms of Small Cell Lung Cancer Symptoms of oat cell lung cancer include swelling in the neck, pain, tenderness, shortness of breath, and persistent coughing. [impactlaw.com]
Psychiatrical
- Aggressive Behavior
Atypical carcinoid tumors have certain microscopic features that indicate the potential for more aggressive behavior. [adasp.org]
Workup
The diagnosis of squamous cell carcinoma of the lung rests on a comprehensive clinical, imaging, and histopathological workup. Firstly, the physician should conduct a detailed patient history (during which the course of symptoms and their severity should be assessed) and perform a meticulous physical examination [8]. Because of the insidious nature of lung cancer in general (including squamous cell carcinoma of the lung), this diagnosis should be considered in all cases who present with undisclosed respiratory and constitutional complaints. Plain radiography of the chest is the first imaging study the needs to be employed, which may show single or multiple masses, hilar enlargement, atelectasis, and many other findings that suggest a malignant process, but some patients have a normal X-ray if smaller tumors are present or if their location renders them poorly visible [4] [9]. For this reason, computed tomography (CT) or positron emission tomography (PET) are recommended [4] [9] [10]. To discriminate between lung tumors and confirm the diagnosis of squamous cell carcinoma of the lung, it is necessary to perform a biopsy of the lesion. A CT-guided percutaneous biopsy or a flexible bronchoscopy with subsequent histopathological examination and immunohistochemistry can be done [9] [10] [11]. Additional methods that may be implemented are conventional bronchoscopy, mediastinoscopy, and aspiration cytology of pleural fluid, whereas electromagnetic navigation (EMN) bronchoscopy and radial endobronchial ultrasound (R-EBUS)-guided lung biopsy are novel techniques that show promising results [4] [9] [11].
Serum
- Hypophosphatemia
Pancoast tumor Horner syndrome Squamous Cell Carcinoma Introduction strong link to smoking more common in men Presentation central (hilar) cavitating lesion can ectopically secrete PTH-related protein (PTHrP) results in parathyroid-like hypercalcemia and hypophosphatemia [medbullets.com]
- Hypophosphatemia
Pancoast tumor Horner syndrome Squamous Cell Carcinoma Introduction strong link to smoking more common in men Presentation central (hilar) cavitating lesion can ectopically secrete PTH-related protein (PTHrP) results in parathyroid-like hypercalcemia and hypophosphatemia [medbullets.com]
Microbiology
- Human Papillomavirus
High-risk human papillomavirus (hrHPV) is an etiologic agent in squamous cell carcinoma (SqCC) arising in the oropharynx and cervix, and a proven prognostic factor in oropharyngeal SqCC. [humpath.com]
Abstract The number of non-small-cell lung cancer (NSCLC) patients reported as infected with human papillomavirus (HPV) varies among countries and by race and geographical location. [ncbi.nlm.nih.gov]
Human papillomavirus infection has been associated with SCCs of the oropharynx, lung, fingers, and anogenital region. [en.wikipedia.org]
Furthermore, the genomic alterations in lung SCC are strikingly similar to those found in human papillomavirus negative head and neck cancers ( 10, 11 ). [doi.org]
Epstein-Barr virus (EBV) and human papillomavirus (HPV) test : A test that checks the cells in a sample of tissue for EBV and HPV DNA. [northshore.org]
Treatment
This overview of the treatment of squamous cell lung carcinoma highlights these recent molecular advances and discusses applications of newer cytotoxic and targeted agents evaluated for the treatment of advanced SCC ( Figure 1 ). [doi.org]
Abstract Treatment for non-small cell lung cancer has been improving, with personalized treatment increasingly becoming a reality in the clinic. Unfortunately, these advances have largely been confined to the treatment of adenocarcinomas. [ncbi.nlm.nih.gov]
Prognosis
HYAL1-wt was associated with a poorer prognosis and HYAL3-v1 with a better prognosis. [ncbi.nlm.nih.gov]
The prognosis of the condition is generally guarded, since the tumors are aggressive. [dovemed.com]
Etiology
Ashy dermatosis is a rare cutaneous disorder of unknown etiology. [ncbi.nlm.nih.gov]
High-risk human papillomavirus (hrHPV) is an etiologic agent in squamous cell carcinoma (SqCC) arising in the oropharynx and cervix, and a proven prognostic factor in oropharyngeal SqCC. [humpath.com]
Etiology Surg Oncol Clin N Am. 2011 Oct;20(4):605-18. Clin Chest Med. 2011 Dec;32(4):605-44. Biochem Pharmacol. 2011 Oct 15;82(8):1015-21. [pathophys.org]
(Etiology) The exact cause of Squamous Cell Carcinoma of Lung is unknown. [dovemed.com]
Epidemiology
Yokohama, Japan. 5 Department of Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious Diseases Center, Komagome Hospital, Tokyo, Japan. 6 Department of Respiratory Medicine, Toranomon Hospital, Tokyo, Japan. 7 Department of Biostatistics and Epidemiology [ncbi.nlm.nih.gov]
Comparison of aspects of smoking among the four histological types of lung cancer S A Kenfield 1, 2, E K Wei 2, M J Stampfer 1, 2, B A Rosner 2, 3, G A Colditz 4 1 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA [doi.org]
He completed a Masters of Medicine (Clinical Epidemiology) and a PhD, also at the University of Sydney. Dr. Ellis moved to Canada in October, 2000. [newevidence.com]
Epidemiological data show recently that overall survival (OS) gains more pronounced for patients with adenocarcinoma histology, less for patients with squamous-cell tumors(2). [medichub.ro]
Epidemiology [ edit ] Lung squamous-cell carcinoma is the second most common histologic type of lung cancer after adenocarcinoma, reaching 22.6% of all lung cancer cases as of 2012. [11] The relative incidence of the former has been steadily decreasing [en.wikipedia.org]
Pathophysiology
Symptoms Mechanism and pathophysiology Primary lung lesion symptoms Cough (50-70%) Presence of a mass irritates the cough receptors in the airway More common in squamous cell carcinoma andSCLC (more commonly found in the central airways) Obstruction from [pathophys.org]
Discussion Visual loss in a patient with systemic cancer can be complicated; the underlying pathophysiology may vary. [journals.lww.com]
Prevention
[…] ar لقد قلت أنني سأقتله- اصغ ، تمهل ثانية en Cervical cancer is preventable, however, by doing cervical smears, which can detect the abnormalities preceding invasive cancer, known as squamous intraepithelial lesion (SIL) and previously known as cervical [glosbe.com]
Smoking prevention and cessation should continue to be the focus of public health efforts to reduce lung cancer incidence and mortality. [doi.org]
The findings might also have cancer prevention implications and dietary implications for patients with cancer — a question the coauthors will address in a planned follow-up animal study of sugar-restricted diets lung tumor progression, according to a [cancertherapyadvisor.com]
Reconstitution Instructions These slides are paraffin coated to prevent sample oxidization, it is recommended that slides are first de-paraffinized by baking at 62 degrees C for 1 hour in a vertical orientation prior to performing antigen retrieval procedures [novusbio.com]
Is It Possible to Prevent Non-Small-Cell Lung Cancer? Lung cancer remains a highly preventable disease because 85% of lung cancers occur in people who smoke or used to smoke. The best way to prevent lung cancer is not to smoke. [emedicinehealth.com]
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