Squamous Cell Carcinoma of the Pancreas

Brown, Hilary; Dotto, Jorge; Robert, Marie E.; Salem, Ronald R.

doi:10.1097/01.mcg.0000180636.74387.e6

Cited by 51 publications

(62 citation statements)

References 17 publications

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“…Other studies revealed that 92% of pancreatic squamous cell carcinomas occur in patients over the age of 50 years 2,9,13 . The analysis of the 25 cases did not show a significant sex preference (there were 14 men and 11 women in the group) 5 , and so pancreatic squamous cell carcinoma seems to affect both sexes equally.…”

Section: Figure 1 Hepatic Biopsy Showing Normal Liver In Lower Quadramentioning

confidence: 99%

“…It has various reported incidence rates, ranging from 0.5% to as high as 5% of pancreatic ductal carcinoma 2,4,5-13 . Halpert and his group (as quoted by Brown et al) in their series of 120 patients, described an incidence rate of 5% pure squamous pathology 5 . However, in a much larger series review such as Baylor and Berg (5075 patients), the reported incidence of pure squamous cell carcinoma was 0.5% of the pancreatic ductal carcinomas 14 .…”

Section: • Connective Tissue Origin • Uncertain Histogenesismentioning

confidence: 99%

“…Differentiation between the atypical squamous epithelium of benign conditions and the cytologic aspirates of carcinoma is possible by noting the small number of atypical cells and the lower degree of nuclear atypia found in the former condition 10 . Squamous metaplasia of the pancreatic ducts is found in 9%-64% of pancreases routinely examined at necropsy, and despite the relative frequency of squamous metaplasia, transformation to squamous cell carcinoma of pancreas is an extremely rare occurrence [4][5][6]8 .…”

Section: • Connective Tissue Origin • Uncertain Histogenesismentioning

confidence: 99%

“…The anatomic head, tail, and body of the pancreas seem to be affected equally by squamous cell carcinoma [4][5][6] . In one report, tumour was located in the head of the pancreas in 73% of cases, the body in 45%, and the tail in 23% (there is some overlap because the tumour may span more than one portion of the organ) 2 .…”

Section: Figure 1 Hepatic Biopsy Showing Normal Liver In Lower Quadramentioning

confidence: 99%

“…Both tend to occur in older people, are usually metastatic at the time of diagnosis, respond poorly to chemotherapy and radiotherapy, and are generally associated with very short survival 2,3,13 . In an analysis of 25 patients, mean age at diagnosis of pancreatic squamous cell carcinoma was 62 years (range: 33-80 years) 5 . Another analysis of 6 patients reported a mean age of 65 years 4 .…”

Section: Figure 1 Hepatic Biopsy Showing Normal Liver In Lower Quadramentioning

confidence: 99%

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Squamous Cell Carcinoma of the Pancreas

Alshehri¹,

Silverman²,

King³

2008

Current Oncology

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Pancreatic malignancies can be subdivided into endocrine and non-endocrine processes. Of the non-endocrine tumours, ductal carcinoma is the most common, and the ductal carcinomas can be further subdivided into adenocarcinomas and squamous cell carcinomas. The adenocarcinomas constitute most of the non-endocrine pancreatic malignancies, and the treatment options for these, although limited in efficacy, are relatively well established. The squamous cell carcinoma pathology is a rare entity, and few reports of it are found in the literature. As a result, treatment options for squamous cell carcinoma of the pancreas are poorly understood. Here, we report the presentation of a 48-year-old woman with metastatic squamous cell carcinoma of the pancreas. The subsequent investigations, treatment, and outcome are described.

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Section: Figure 1 Hepatic Biopsy Showing Normal Liver In Lower Quadramentioning

confidence: 99%

Section: • Connective Tissue Origin • Uncertain Histogenesismentioning

confidence: 99%

Section: • Connective Tissue Origin • Uncertain Histogenesismentioning

confidence: 99%

Section: Figure 1 Hepatic Biopsy Showing Normal Liver In Lower Quadramentioning

confidence: 99%

Section: Figure 1 Hepatic Biopsy Showing Normal Liver In Lower Quadramentioning

confidence: 99%

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Squamous Cell Carcinoma of the Pancreas

Alshehri¹,

Silverman²,

King³

2008

Current Oncology

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

et al. 2020

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Background The prognosis for nonmetastatic, primary pancreatic squamous cell carcinoma (SCC) is thought to be poor compared with adenocarcinoma (AC); however, this is based on limited data. Additionally, the optimal definitive treatment strategy for nonmetastatic pancreatic SCC is unknown. Methods We analyzed patients with nonmetastatic pancreatic cancer using the National Cancer Database for patients diagnosed from 2006 to 2014. Patients were analyzed according to histology—only AC, adenosquamous carcinoma (A‐SCC), and SCC were included. The primary endpoint was overall survival (OS) from the time of diagnosis. Results A total of 94 928 cases were included; 94 016 AC, 757 A‐SCC, and 155 SCC. Median OS was lower for SCC (8.67 months), compared to AC (13.93 months) and A‐SCC (12.71 months, P < .001). SCC was resected less often (25.5% vs 46.7% and 74.5%). On subgroup analysis of patients with pancreatic SCC, factors on multivariate analysis associated with improved survival included surgery (HR 0.19, P < .001), and chemotherapy (HR 0.22, P = .01). In 38 patients with SCC undergoing surgical resection, median OS improved (MS = 6.8 months without surgery vs 21.3 months with surgery, P < .001). Conclusions Nonmetastatic pancreatic SCC presents with more advanced disease, which is less often surgically resected or treated with any definitive local therapy. In contrast, AC and A‐SCC behave more similarly and have higher surgical resection rates and improved survival. In patients with nonmetastatic SCC of the pancreas, surgical resection provides the most significant survival benefit, with systemic chemotherapy providing a less significant benefit, and localized radiation providing no statistical benefit for any subgroup.

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Cytologic differentiation of squamous elements in the pancreas

Bixler

Castro

Stewart

2010

Diagnostic Cytopathology

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There are numerous histologically varied types of epithelial neoplasms of the pancreas with broad categorization as either exocrine or endocrine tumors according to dominant cell type and or elaboration of peptide hormones by neoplastic cells. Subclassification of these tumors is based in large part on whether they are grossly solid, cystic, or intraductal and by their histological differentiation. Exocrine tumors are by far the most common with invasive ductal adenocarcinoma representing 85% of all pancreatic neoplasms. 1 Rare histological variants such as adenosquamous and its subset of squamous-cell carcinoma are infrequently described in the literature with both having a reported incidence of 1-4 and 0.5% of all exocrine pancreatic neoplasms, respectively. 2,3 Other squamous lesions, such as benign lymphoepithelial cysts of the pancreas are also uncommon (less than 100 cases reported in the literature) and can be misdiagnosed as pancreatic masses or cystic neoplasms. [4][5][6] The normal pancreas is histologically devoid of native squamous elements. However, benign squamous metaplasia is reported in 9-64% of pancreases examined postmortem. Squamous metaplasia can be present in conditions associated with chronic inflammation such as chronic pancreatitis and pancreatic/biliary stent placement. It is also uncommonly identified in the adjacent ducts of 4% of surgical specimens resected for pancreatic adenocarcinoma 2 and rarely in benign pancreatic mucinous neoplasms. 7 Malignant squamous cells in the pancreas have been postulated to evolve through various mechanisms including malignant transformation of squamous metaplasia, squamous metaplastic change of a pre-existing adenocarcinoma, and differentiation with malignant transformation of primitive multipotent cells. 4,8 The rarity of pure squamous-cell carcinoma in the pancreas has led many investigators to question if this is truly a distinct pathologic entity, an under sampled primary pancreatic adenosquamous carcinoma, or most likely metastasis from an occult primary. 2,9 When diagnosed by fine-needle aspiration (FNA), the presence of squamous epithelium in a pancreatic lesion raises a broad differential including skin contaminants in percutaneous needle biopsies, atypical metaplasia, benign cysts with squamous differentiation, metastasis, or adenosquamous/squamous-cell carcinoma. Skin contaminants with bland cytologic features are easily distinguished from atypical metaplasia or carcinoma and rarely cause diagnostic confusion. Atypical squamous metaplasia can range in appearance from reactive to more atypical. Atypical squamous metaplastic features that have been reported demonstrate mild to moderate nuclear hyperchromasia, nuclear variation in size with enlargement up to four to five times normal, and nuclear membrane irregularity with relative preservation of nuclear/cytoplasmic ratios. Layfield et al. noted in their review of nine FNA cases containing squamous elements that atypical squamous metaplasia could be distinguished from adenosquamous/squamous-cel...

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Squamous Cell Carcinoma of the Pancreas

Cited by 51 publications

References 17 publications

Squamous Cell Carcinoma of the Pancreas

Squamous Cell Carcinoma of the Pancreas

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

Cytologic differentiation of squamous elements in the pancreas

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