Pancreatic Squamous Cell Carcinoma

Abstract

Pancreatic squamous cell carcinoma (SCC) is a rare event. Here, we present a 56-year-old man with pancreatic SCC. Imaging methods demonstrated a hypodense mass at the head and trunk of the pancreas. Also, some lymphadenopathy has been seen around the pancreas and para-aorta. The mass created pressure and encasement on the celiac trunk, portal vein, and arteries of the liver and spleen. Endoscopic ultrasound showed a mass lesion of 45–37 mm (mixed echoic) at the trunk of the pancreas. Histological examination of the endoscopic ultrasound-guided fine needle aspiration specimen confirmed the diagnosis of SCC. The disease is highly aggressive, most often locally advanced or metastatic at diagnosis, and poorly responsive to treatment. It also has generally poor survival rates.

Adenosquamous and squamous cell carcinoma of the pancreas: two histopathological variants of ductal adenocarcinoma

“…As the normal pancreatic tissues does not include squamous epithelium, it is still unclear the histogenesis of primary tumors with squamous component [4,5,6,12]. It was even postulated the origin in a pluripotent primitive-or remnant aberrant squamous cell from embryonal period [1,[4][5][6][7]11,[13][14][15], or, based on other authors, it is rather about a collision tumor than a really pure SCC, in which the tumor stem cells from glandular part might be dedifferentiated in cells with squamous arhitecture [1,6,7,11]. On the other hand, as most of the pancreatic cancers occur on the background of chronic pancreatitis, metaplastic transformation can be the precursor lesion [1,[4][5][6][7].…”

“…It was even postulated the origin in a pluripotent primitive-or remnant aberrant squamous cell from embryonal period [1,[4][5][6][7]11,[13][14][15], or, based on other authors, it is rather about a collision tumor than a really pure SCC, in which the tumor stem cells from glandular part might be dedifferentiated in cells with squamous arhitecture [1,6,7,11]. On the other hand, as most of the pancreatic cancers occur on the background of chronic pancreatitis, metaplastic transformation can be the precursor lesion [1,[4][5][6][7]. As in our second case the immunoprofile was similar in both glandular and squamous component we tend to believe that like adeno-neuroendocrine tumors (MANEC), adeno-squamous and SCC of the pancreas have the same origin in a Fig.…”

“…Adeno-squamous cell carcinoma of the pancreas is characterized by proliferation of ductal structures and solid areas (A). Both components showed an immunophenotype suggesting ductal (B) and squamous differentiation (C) through an epithelial-mesenchymal transition (E) pluripotent stem tumor cell which might show dual differentiation [1,6,7,11,[16][17][18][19]. Vimentin positivity was suggestive for the epithelial-mesenchymal transition (EMT) phenomenon, which, like other histopathological subtypes of pancreatic cancer, seems to explain the tumor aggressivity [20].…”

“…Rare variants such papillary of adenosquamous pancreatic carcinomas are also encountered in daily diagnosis but pure primary squamous cell carcinoma (SCC) of the pancreas is an unusual tumor which differential diagnosis is difficult to be done [4,5]. For such diagnosis, metastatic lesions need to be excluded [1,6,7].…”

The impact of squamous cell carcinoma histology on outcomes in nonmetastatic pancreatic cancer

“…In a study of 206 pancreas autopsy specimens from patients with no known history of cancer, Mukada et al reported squamous metaplasia in 16.4% of cases . It is unclear how primary SCC develops in an organ histologically devoid of native squamous cells; theories include development from a progenitor cell, malignant transformation of inflammatory‐induced squamous metaplasia (possibly related to chronic pancreatitis or pancreatic stent placement), and squamous transformation of AC . (Figure ) Others hypothesize that primary SCC of the pancreas is, in fact, metastatic SCC arising in an occult primary elsewhere in the body …”