Squamous Cell Carcinoma of Lung in a Young Female Patient with Myasthenia Gravis
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 19, Issue 3
Abstract
Lung cancer incidence is increased among the younger population, and various factors are being responsible for that [1,2]. Accompaniment of myasthenia gravis with solid tumors like lung cancer is reported [3,4]. A 28 year old housewife with persistent cough and exertional shortness of breath diagnosed with squamous cell carcinoma, she also has a history of seropositive myasthenia gravis, diagnosed 12 years ago, with right sided petosis, hoarseness and dysphagia. It seems that a history of thymoma increases the chance of extra thymic malignancies [3-5]. Occurrence of cancer in these patients might be synchronous or a few years before or after the onset of MG. Long-term exposure to corticosteroids and the 12-year history of MG are seemingly the leading causes of cancer development in this young female. Lung cancer incidence is increased with the process of ageing and numerous factors are involved in the pathogenesis of this disease. on the other hand, it is becoming more prevalent among the younger population, with various factors such as gene mutatations, a history of pulmonary disease, a family history of cancer and dysregulation of the immune system, being responsible for that [1,2]. Accompaniment of myasthenia gravis with solid tumors like lung cancer is reported in a number of studies [3,4]. Here, we present a case of 28-year-old, non-smoker, female with squamous cell carcinoma of lung and a 12 year history of myasthenia gravis. 28-year-old housewife is referred to the oncology clinic with the chief complaint of persistent cough and episodes of exertional shortness of breath. The patient also complains of a chest discomfort and a significant weight loss of 10kg in the last two months. No complaints of hemoptysis are mentioned. She gives no history of environmental or occupational exposure and has never smoked in the past. The productive cough began 5 months prior to admission and has been treated with the diagnosis of pneumonia, due to lack of improvements, further investigation was conducted, leading to the diagnosis of a non-small cell lung cancer. Pathologic analysis revealed a non-small cell lung carcinoma, morphologically consistent with a squamous cell carcinoma, IHC staining results were positive for p63 and cytokeratin and negative for TIF1, NSE and synaptophysin markers, further confirming the diagnosis of SCC. The patient has a history of seropositive myasthenia gravis, diagnosed 12 years ago. MG manifested with right sided petosis, hoarseness and dysphagia, gradually causing involvement of other muscles.
Authors and Affiliations
Abdolali Shahrasbi, Mandana Mirzaei, Delaram Amiri, Binazir Borukhian, Zahra Mahboubi
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