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Basaloid squamous cell lung carcinoma is a rare subtype of non-small cell lung cancer, accounting for 3.9–5.2% of all lung squamous carcinomas. The prognosis is still debated and there is limited evidence regarding the efficacy of immunotherapy in this relatively uncommon population. Case Report: We report a case of basaloid squamous cell lung carcinoma, which was initially diagnosed as small cell carcinoma before completion of all immunohistochemical tests. The patient received seven doses of nivolumab after progression on chemotherapy. Although the treatment had to be interrupted due to colitis, she had a nearcomplete response. Conclusion: Besides illustrating the importance of immunohistochemical staining to aid in accurate diagnosis, this case also demonstrates the deep and durable response to nivolumab. The patient responded significantly better than the reported median progression free survival for squamous cell carcinoma with second line nivolumab. Although this case report Prajwol Shrestha1,2, Laura Mackenzie3, Karan Taneja4, Mathew Kattathra George5, Sunil Rai5 Affiliations: 1Medical Registrar (AT), Medical Oncology, Northwest Cancer Centre, Tamworth Hospital, Tamworth, NSW, Australia; 2Calvary Mater Newcastle Hospital, Waratah, NSW, Australia; 3Resident Medical Officer, General Surgery, Tamworth Hospital, Tamworth, NSW, Australia; 4Senior Resident Medical Officer, Emergency Department, Tamworth Hospital, Tamworth, NSW, Australia; 5Staff Specialist, Medical Oncology, Northwest Cancer Center, Tamworth Hospital, Tamworth, NSW, Australia. Corresponding Author: Dr. Prajwol Shrestha, Department of Medical Oncology, Calvary Mater Newcastle Hospital, Corner Edith and Platt Street, Waratah, NSW 2298, Australia; Email: Prajwol.shrestha@calvarymater.org.au Received: 12 July 2020 Accepted: 13 August 2020 Published: 25 September 2020 PEER REVIEWED | OPEN A CE S demonstrates a remarkable response, it will be important to validate the predictive response to nivolumab in large randomized studies.

journal of case reports and images in oncology

Diagnostic and management dilemma in basaloid squamous cell carcinoma of lung showing significant response to immunotherapy: Case report and literature review