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Unusual presentation of more common disease/injury
Case report
Rare basal cell metastasis of a basal-squamous skin collision tumour to the lung and axillary lymph node
  1. Rui Li1,
  2. Gina Lee1,2,
  3. Min Huang3 and
  4. Ahmed El-Sherief4,5
  1. 1 Pulmonary and Critical Care, UCLA, Los Angeles, California, USA
  2. 2 Pulmonary and Critical Care, Greater Los Angeles Veteran Affairs Medical Center, Los Angeles, California, USA
  3. 3 Pathology, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, California, USA
  4. 4 Radiology, UCLA, Los Angeles, California, USA
  5. 5 Radiology, Greater Los Angeles Veterans Affairs Healthcare System, Los Angeles, CA, United States
  1. Correspondence to Dr Gina Lee; gina.lee{at}va.gov

Abstract

We report a case of a 60-year-old man who was a former cigar smoker with a slow-growing, large exophytic left shoulder mass (15 cm in diameter) and later found to have left axillary lymphadenopathy. Fine needle aspirate biopsy of the left shoulder mass revealed squamous cell carcinoma (SCC). However, pathology of the enlarged left axillary lymph node was reported as metastatic adenocarcinoma. The patient underwent surgical resection of the shoulder mass which comprised of SCC (>95%) and adenoid basal cell carcinoma (BCC) as a second component of the tumour. The BCC had identical histology as the metastatic carcinoma in the left axillary lymph node. Therefore, diagnosis was revised as cutaneous collision tumour with metastatic BCC. Six months later following adjuvant radiation therapy, the patient was diagnosed with metastatic BCC in the right lung. Stereotactic body radiation therapy (SBRT) and a selective hedgehog pathway inhibitor vismodegib were given with only limited efficacy. Clinical trial registration number NCT03132636.

  • lung cancer (oncology)
  • skin cancer

https://doi.org/10.1136/bcr-2019-231487

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    Footnotes

    • Contributors RL and GL wrote the case report. MH provided intellectual input for the discussion. MH and AE-S provided radiology and pathology images. RL and GL finalised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.