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Multiple keratin granulomata: A potential histologic clue to cutaneous squamous cell carcinoma responding to

Benjamin J Kahn1, Douglas Parker1, Melinda Yushak2

  • 1Department of Dermatology, Emory University School of Medicine, Atlanta, Georgia.

Journal of Cutaneous Pathology
|February 28, 2019
PubMed

Insights

Pembrolizumab shows efficacy in treating advanced cutaneous squamous cell carcinoma (cSCC). Histologic examination reveals specific features like keratin granulomata in cSCC responding to PD-1 antagonist therapy.

Area of Science:

  • Oncology
  • Dermatology
  • Immunohistochemistry

Background:

  • Cutaneous squamous cell carcinoma (cSCC) is a common skin cancer.
  • Surgically unresectable cSCC poses treatment challenges.
  • Programmed cell death protein-1 (PD-1) antagonists offer a therapeutic option.

Observation:

  • Histologic features of cSCC treated with pembrolizumab were analyzed.
  • Partial response was observed in a patient with locally advanced cSCC.
  • Specific microscopic changes were noted during PD-1 antagonist treatment.

Findings:

  • Pembrolizumab demonstrated efficacy in a case of locally advanced cSCC.
  • Key histologic findings included keratin granulomata with lymphocytic aggregates and fibrosis.
  • These features are associated with response to PD-1 blockade in cSCC.

Implications:

  • This case supports pembrolizumab's role in managing unresectable cSCC.
  • Understanding treatment-related histologic changes aids in evaluating therapeutic response.
  • Further research into PD-1 inhibitor mechanisms in cSCC is warranted.
Keywords:
histologyimmunomodulationsquamous cell carcinomatumor-infiltrating lymphocytes

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