Cutaneous Squamous Cell Carcinoma with Signet-Ring Cell Component and CDX2 Expression in a Patient Treated with PD-1 Inhibitor: A Case Report of a Common Tumor with Unusual Differentiation.

IF 0.7 Q4 PATHOLOGY Case Reports in Pathology Pub Date : 2023-01-01 DOI:10.1155/2023/3378044
Sherehan Zada, Jeremiah Tao, Maria Del Valle Estopinal
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Abstract

Signet-ring cell squamous cell carcinoma (SRCSCC) is an uncommon variant of cutaneous SCC that has been reported in the head and neck region. Herein, we present a case of a 56-year-old female with a cutaneous SCC that recurred after surgical excision, during treatment with cemiplimab (a programmed death receptor-1 (PD-1) inhibitor). Histologically, the recurrent SCC revealed a second component characterized by the presence of signet-ring-like cells (SRLCs). Immunohistochemical studies demonstrated that the tumor cells were positive for P63, CK5/6, CDX2, and P53 while negative for P16, CK7, CK20, and CD68 stains. An abnormal expression of B-catenin was also observed in the tumor. To our knowledge, SRCSCC developing during treatment with an immune checkpoint inhibitor has not been documented in the literature. Our findings suggest a form of acquired SCC cell resistance to immunotherapy that might involve CDX2-related pathways.

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PD-1抑制剂治疗伴有印戒细胞成分和CDX2表达的皮肤鳞状细胞癌:一例罕见分化的常见肿瘤
印戒细胞鳞状细胞癌(SRCSCC)是一种罕见的皮肤鳞状细胞癌,已报道在头颈部区域。在此,我们报告了一例56岁的女性皮肤鳞状细胞癌,手术切除后,在使用西米单抗(一种程序性死亡受体-1 (PD-1)抑制剂)治疗期间复发。组织学上,复发的SCC显示了第二种成分,其特征是存在印戒样细胞(srlc)。免疫组化研究显示肿瘤细胞P63、CK5/6、CDX2和P53阳性,而P16、CK7、CK20和CD68阴性。b -连环蛋白在肿瘤中也有异常表达。据我们所知,在免疫检查点抑制剂治疗期间发生的SRCSCC尚未在文献中记载。我们的研究结果表明,获得性SCC细胞对免疫治疗的抵抗可能涉及cdx2相关途径。
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审稿时长
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