Adenosquamous carcinoma of the pancreas: a case report

Abstract

Adenosquamous carcinoma of the pancreas is a rare variant of pancreatic exocrine carcinoma. We report a case of 70 year old man who came to our hospital with abdominal pain, anorexia and jaundice. Imaging of the abdomen showed a mass in the region of the head of the pancreas. Histological evaluation of the pancreatic tumor showed an adenosquamous carcinoma which was extensively infiltrative with perineural invasion, involvement of peripancreatic lymph nodes and all the thickness of the duodenum wall. The tumor exhibited a biphasic malignant growth identified as well to moderate differentiated adenocarcinoma and well to poorly differentiated squamous cell carcinoma.

Clinical Characteristics of Adenosquamous Carcinoma of the Pancreas

“…1Y3 Adenosquamous carcinoma of the pancreas (ASC) is one such mixed neoplasm, exhibiting both glandular and squamous differentiation. 4Y6 Herxheimer 7 reported the first case of ASC in 1907, but despite the accumulation of reports, most descriptions have been from case studies 8 and small surgical series. 9 Adenosquamous carcinoma of the pancreas has anecdotally been considered aggressive and has shown poor prognosis compared with pancreatic ductal adenocarcinoma (PDAC).…”

Adenosquamous Versus Adenocarcinoma of the Pancreas: A Population-Based Outcomes Analysis

“…The clinical significance of this diagnosis is unclear, however, because its natural history is poorly understood. Indeed, the demographics, treatment patterns, and oncologic outcomes of patients with ASC are essentially unknown because all clinical knowledge of the disease has been accumulated from case studies 8 – 26 and small, single-institution anecdotes—reporting patients compiled over a period of decades—the overwhelming majority of whom had localized disease and were treated with surgery alone. 2 , 5 , 7 , 27 – 31 Given the time, stage, and treatment biases inherent in these previous reports, we hypothesized that the natural history of ASC has been mischaracterized and its clinical significance overstated.…”

Comparative outcomes of adenosquamous carcinoma of the pancreas: An analysis of the National Cancer Database

“…4 The proportion of squamous cell differentiation, either <30% or ≥30%, does not appear to predict overall survival. 5 The relative rarity of ASCP has limited the characterization of clinicopathological variables associated with outcome to case studies, [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] single institution studies with a paucity of patients 3,5,[24][25][26][27][28][29] or examination of administrative datasets with limited co-variate availability. 30,31 Most series report a poor prognosis for patients with ASCP with median overall survival ranging from 4 to 19 months depending on surgical resection and/or the receipt of adjuvant chemotherapy.…”