Rapid killer: Lung squamous cell cancer

Abstract

Background: Lung cancer is one of the leading causes of death despite improvement in treatment modalities such as immunotherapy with chemotherapy and precise radiotherapy. NSCLC is a heterogeneous group of diseases that differs in cytology and includes adenocarcinoma, squamous cell carcinoma, bronchioloalveolar carcinoma, and poorly differentiated carcinoma. Usually, NSCLC, in contrast to SCLC, spreads locally, and the doubling time of squamous cell carcinoma is 133 days which classifies it as a relatively slow-growing tumor.

Case presentation: We present the case of a 72-year-old male, recently diagnosed with squamous cell carcinoma in the right upper lobe along with secondary deposits. Few days after diagnosis, the patient had severe respiratory distress. This endobronchial tumor has increased significantly in size upon bronchoscopic visualization causing a complete obstruction of his right main bronchus and hypoxemic respiratory failure requiring intubation.

Conclusion: To our knowledge, there are few reported cases where lung adenocarcinoma progressed rapidly over days. Squamous cell carcinoma usually takes 3 to 6 months to double in size, but in our case, the progression was very fast. In the last decade, it was confirmed that the doubling time of a tumor is an independent factor in the prognosis of lung cancer patients. On the other hand, further studies are needed to identify genes associated with rapid progression and a worse prognosis for lung squamous cell carcinoma. Hence, this aggressive tumor is a “rapid killer.”