Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2021; 9(4): 976-982
Published online Feb 6, 2021. doi: 10.12998/wjcc.v9.i4.976
Primary nonkeratinizing squamous cell carcinoma of the scapular bone: A case report
Yang Li, Jian-Lin Zuo, Jin-Shuo Tang, Xian-Yue Shen, Sheng-Hao Xu, Jian-Lin Xiao
Yang Li, Jian-Lin Zuo, Jin-Shuo Tang, Sheng-Hao Xu, Jian-Lin Xiao, Department of Orthopedics, China-Japan Union Hospital of Jilin University, Changchun 130033, Jilin Province, China
Xian-Yue Shen, Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130033, Jilin Province, China
Author contributions: Li Y, Tang JS, Shen XY, Xiao JL, and Zuo JL were the clinicians involved in the patient’s diagnosis, management, therapy, and follow-up; Li Y reviewed the literature and contributed to drafting the manuscript; Xiao JL contributed to reviewing the literature and drafting the manuscript; Xiao JL and Zuo JL analyzed and interpreted the imaging findings; Xiao JL was responsible for the critical revision of the manuscript for relevant intellectual content; All authors approved the final version of the paper prior to submission.
Informed consent statement: The patient consented to the publication of this study.
Conflict-of-interest statement: The authors declare that there is no conflict of interest in this work.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jian-Lin Xiao, MD, PhD, Chief Doctor, Postdoc, Department of Orthopedics, China-Japan Union Hospital of Jilin University, No. 126 Xiantai Street, Changchun 130033, Jilin Province, China. xiaojianlin10@jlu.edu.cn
Received: November 9, 2020
Peer-review started: November 9, 2020
First decision: December 8, 2020
Revised: December 9, 2020
Accepted: December 23, 2020
Article in press: December 23, 2020
Published online: February 6, 2021
Processing time: 77 Days and 2.3 Hours
Abstract
BACKGROUND

Squamous cell carcinoma (SCC) of bone is usually caused by metastasis from the lungs, bladder, or other sites. Primary SCC of bone most frequently involves the skull bones, and primary involvement of other sites in the skeletal system is extremely rare. To date, only three such cases have been reported, which makes the diagnosis, treatment, and prognosis of this disease a challenge.

CASE SUMMARY

A 76-year-old Chinese man presented to our hospital with nonspecific pain and limited mobility in the right shoulder for 4 mo. He underwent three-dimensional computed tomography reconstruction and magnetic resonance imaging of the right shoulder, which revealed an osteolytic destructive lesion in the right scapula with invasion into the surrounding muscles and soft tissues. Ultrasound-guided core needle biopsy detected a malignant tumor, and immunohistochemical analysis revealed a poorly differentiated SCC. Wide excision of the right scapular bone was performed, and pathological examination of the surgical specimen confirmed the diagnosis. At the last follow-up examination within 2 years, the patient was doing well with the pain significantly relieved in the right shoulder.

CONCLUSION

Primary SCC of bone is extremely rare at sites other than the skull. Clinicians must exhaust all available means for the diagnosis of primary SCC of the bone, so greater attention can be paid to its timely and effective management. Regular and adequate follow-up is essential to help rule out metastasis and judge the prognosis.

Keywords: Primary squamous cell carcinoma; Keratin pearls; Scapular bone; Diagnosis; Immunohistochemistry; Case report

Core Tip: To the best of our knowledge, the present case represents the fourth case of primary squamous cell carcinoma (SCC) of a bone outside the skull and the first case of primary nonkeratinizing SCC of the scapular bone. Our findings suggest the need to improve the techniques used for the diagnosis of primary SCC of bones outside the skull, so greater attention can be paid to timely and effective management. Moreover, it is necessary to rule out metastasis and judge the prognosis with regular and adequate follow-up.