Unusual Spindle Cell Squamous Carcinoma in a Renal Transplant Patient

Abstract

High-dose intravenous immunoglobulin has been proposed as an alternative treatment for several immuno-mediated inflammatory skin diseases, usually at a dosage of 1 - 2 g/kg. We describe the treatment of 10 patients affected by toxic epidermal necrolysis using 400 mg/kg per day on 5 consecutive days--a schedule that is lower than previously reported schedules. According to the SCORTEN, the earlier predicted mortality rate was 35%. After high-dose intravenous immunoglobulin therapy, a mortality rate of 10% and a survival rate of 90% were reached. In particular, nine patients showed a dramatic improvement already after one course of infusion started at an early stage of the disease. It is our experience, and that of others, that high-dose intravenous immunoglobulin can be considered the drug of first choice for toxic epidermal necrolysis, one of the most severe life-threatening dermatological conditions, and a valid alternative therapy for different long-standing chronic dermatological diseases. This therapy can also be effective in avoiding high steroid dosages and consequently steroid-related or immunosuppressive-related side effects. It is therefore reasonable to propose high-dose intravenous immunoglobulin treatment as a valuable therapeutic tool for dermatologists.

The Effect of Intravenous Immunoglobulin Combined with Corticosteroid on the Progression of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis: A Meta-Analysis

“…Of these, 9 selected TEN patients[26, 31, 40, 45–50] and 8 recruited patients without restriction[10, 11, 25, 27, 43, 51–53], which accumulated 361 cases treated by IVIG within this analysis. In terms of therapy, 167 patients were given solo IVIG treatment[10, 11, 46, 47, 49–52], 189 patients were treated with combination of IVIG and steroid[25–27, 31, 40, 43, 45, 53], and 5 patients were treated with IVIG and plasmapheresis[48]. Some articles also reported the time to recover or in hospital with no control to compare with[50, 52, 53].…”

Osteoclast-Like Giant Cell Reaction Associated With Cutaneous Squamous Cell Carcinoma: A Report of 2 Cases and Review of the Literature

“…Whether this observation is attributable to the propensity of these patients to develop sarcomatoid squamous cell carcinomas, which in contrast to well-differentiated variants seem to attract O-LGCs, or to an alteration in the host response due to immunosuppression, is unclear. 12,13 At this time, there is insufficient data in the literature to determine the potential prognostic influence of O-…”

Spindle Cell Squamous Cell Carcinoma Showing Continuous Mesenchymal Dedifferentiation in a Single Tumor

“…Spindle cell squamous cell carcinoma (SCSCC) has been found in areas of sun‐exposed skin, burn scars, and chronic radiation dermatitis, but also in patients who had never been treated with X‐rays (1, 2). SCSCC developed in a renal transplant patient (3) and a patient with long‐standing erythoderma (4). The tumor preferentially occurs in the skin of elderly males and is clinically indistinguishable from other SCC types (5, 6).…”