Case Study on Primary Squamous Cell Carcinoma of Pleura Masquerading as Tuberculous Abscess: A Rare Disease

Abstract

Primary pleural SCC is a rare pleural malignancy which has seldom been reported. This case report aims to highlight the unique presentation of pleural SCC and to create awareness among pathologists about this entity. Here we report a case of a 47-year male who presented with low-grade fever, persistent chest pain and loss of appetite for 3 months along with a positive history of contact. Physical examination and chest roentgenograms revealed a right-sided pleural effusion. CECT thorax demonstrated fluid collection in the pleural space along with a fibrotic patch and cytology revealed extensive necrosis. Based on the above finding a provisional diagnosis of tuberculous abscess was made and subsequently, anti-tuberculous treatment was started. Later on, after 3 months patient again presented with similar complaints and a physical examination revealed a bulging mass on the back which was aspirated and sent for cytology which revealed features consistent with the diagnosis of poorly differentiated squamous cell carcinoma. This was later confirmed by CECT thorax, showing a heterogeneous mass with pleural thickening and invasion. Histopathology eventually confirmed the diagnosis of primary pleural squamous cell carcinoma. Local excision with an intraoperative assessment of the surgical margins remains the treatment of choice for pleural nodules. The preferred procedure for excision is video-assisted thoracic surgery (VATS) as it is minimally invasive.