Primary adenosquamous carcinoma of the jejunum

Abstract

Adenosquamous carcinomas of the small intestine are extremely rare, with only three documented jejunal and three ileal cases being reported in the English-language medical literature. Presented herein is a case of primary jejunal adenosquamous carcinoma in an 80-year-old woman. The jejunal carcinoma consisted predominantly of a squamous component throughout the tumor but peritoneal nodules carrying metastases from the adenocarcinoma element were noted, making it the first case of jejunal adenosquamous carcinoma with metastases from the adenocarcinoma component. The finding that metastases could arise from the minor component of a jejunal adenosquamous carcinoma indicates that an accurate diagnosis must be based upon thorough examination of both the primary and the metastases, not just mesenteric nodule biopsy alone. Histological foci of closely intermingled squamous and glandular components with apparent morphological transition were noted, indicating the pathogenetic possibility that the squamous component might arise by transformation from the glandular element. The squamous component was strongly positive with immunostaining for p63 (nuclear staining) and for cytokeratin 10/13 (cytoplasmic staining), while the adenocarcinoma element was negative. The immunohistochemical results suggest that p63 and cytokeratin 10/13 might be useful in identifying squamous differentiation in jejunal carcinoma.

A clinicopathological and immunohistochemical study of gastric cancer with squamous cell carcinoma components: A clinically aggressive tumor

“…In this study, adenocarcinoma components were present in the superficial layer of tumors in all patients. In most patients the SCC components were associated with an apparent transition zone from glandular components 1 and adjoined adenocarcinoma components. The expression pattern of tumor suppressor gene p53 product was nearly identical in both components 14 .…”

“…Adenosquamous carcinoma (ASC) has been reported to occur throughout the gastrointestinal and hepatobiliary tracts 1–6 . Primary ASC of the stomach consists of both adenocarcinoma and squamous cell carcinoma (SCC) components, with the latter accounting for at least 25% of the tumor cells 7 .…”

Intestinal obstruction caused by primary adenosquamous cell carcinoma of the small intestine: A case report and review of the literature

“…Due to its rarity, the clinicopathological characteristics and survival outcomes of intestinal ASCC have not been clearly determined. The previous reports are summarized in Table I ( [13][14][15][16][17][18][19][20]. Almost all patients had abdominal pain as a chief complaint, and their median age was 76 years (range, 55-80 years).…”

Squamous cell carcinoma of the small intestine

“…7 However, lymphomas and endocrine tumours are almost as frequent as carcinomas. 8 Adenocarcinomas are still sometimes described as case reports. 9 Primary squamous cell carcinomas of small intestine are exceptionally rare with only occasional case reports in literature.…”