1
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Ford JA, Bhatt A, Kim RC, Larkins M, Burke AM. Primary squamous cell carcinoma of the pancreas: an update on a rare neoplasm from the SEER database. Front Oncol 2023; 13:1272740. [PMID: 38130988 PMCID: PMC10733453 DOI: 10.3389/fonc.2023.1272740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/05/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Pancreatic squamous cell carcinoma is a rare type of pancreatic cancer of ductal origin, composing an estimated 0.5 - 5% of pancreatic ductal malignancies. As a result, epidemiology, treatment options, and associated outcomes are poorly understood and understudied. Our aim was two-fold: to evaluate demographic trends and analyze overall survival (OS) associated with different treatment modalities for this rare malignancy. Methods Patients with pancreatic squamous cell carcinoma diagnosed between 1992 and 2019 were eligible and reviewed utilizing the Surveillance, Epidemiology, and End Results Registry (SEER) database. Data was analyzed using SPSS and python packages lifelines and pandas. Variables of interest included stage at diagnosis as well as the receipt of surgery, radiotherapy, and/or chemotherapy. Five-year OS curves were analyzed using Kaplan-Meier probability stratified by treatment modality. Results Of 342 cases of pancreatic squamous cell carcinoma, 170 (49.7%) were females and 172 (50.3%) were males. 72 (21.1%) of patients received radiotherapy, 123 (35.9%) patients received chemotherapy, and 47 (13.7%) received surgery. Patients who were diagnosed under the age of 50 had prolonged survival time compared to those diagnosed over the age of 50 (12 vs 8 months, respectively, p < 0.001). This trend was evident despite the lack of a significant association between age at diagnosis and presence of metastases (p = 0.524). The median OS was 3 months for the entire cohort and there was a significant difference in median survival time noted across treatment modalities: OS was prolonged in those receiving surgery compared to those receiving chemotherapy or radiotherapy alone (30 vs 2 months, respectively, (p<0.001)). Receipt of radiotherapy was not associated with a significant difference in OS compared to those who did not receive radiotherapy. Conclusion Pancreatic squamous cell carcinoma is a rare subtype of pancreatic cancer and typically portends a poor prognosis. As demonstrated by our study, surgery offers prolonged overall survival compared to other treatment modalities. Age at diagnosis and presence of metastatic disease are also important prognostic factors likely related to patients' ability to tolerate surgery or physician willingness to offer surgery. Given the importance of surgery on outcomes, it may be reasonable to offer it in the oligometastatic setting in patients who are otherwise a good candidate. Future research on larger cohorts is warranted to investigate the role that modality selection plays in overall survival rates in this understudied malignancy.
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Affiliation(s)
- Jacob A. Ford
- Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Arjun Bhatt
- Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Rachel C. Kim
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN, United States
| | - Michael Larkins
- Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Aidan M. Burke
- Brody School of Medicine, East Carolina University, Greenville, NC, United States
- Department of Radiation Oncology, East Carolina University (ECU) Health, Greenville, NC, United States
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2
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Mano Y, Sugimachi K, Shimagaki T, Tomino T, Onishi E, Lee L, Hisano T, Koga Y, Taguchi K, Morita M, Toh Y. Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report. Surg Case Rep 2023; 9:173. [PMID: 37773552 PMCID: PMC10541355 DOI: 10.1186/s40792-023-01755-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 09/16/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Liver metastasis of pure squamous cell carcinoma (SCC) from pancreatic ductal adenocarcinoma has not been previously reported. CASE PRESENTATION A 66-year-old man underwent a computed tomography scan 3 years after surgery for pancreatic head cancer, and the scan revealed a mass lesion in the right lobe of the liver. A liver tumor biopsy was performed, and SCC was diagnosed. Whole sections of the pancreatic head cancer were re-evaluated, but no areas of SCC-like differentiation were identified. Although the pathology differed between the pancreas and liver, metastasis of adenosquamous carcinoma was considered. Three courses of gemcitabine plus nab-paclitaxel were administered to treat the liver metastasis of pancreatic cancer, but no response was attained. Therefore, primary SCC of the liver was considered and hepatic resection was performed. The tumor had invaded the diaphragm, and S5/6 partial hepatic resection with right diaphragm resection was performed. Pathological examination showed pure SCC of the liver, which differed from the pancreatic cancer. KRAS mutations were evaluated in the pancreatic and liver tumor specimens, and Q61R mutation was identified in both specimens. This pure SCC of the liver was diagnosed as metastasis from pancreatic cancer not by histology but by genetic analysis. CONCLUSIONS This is the first reported case of pure SCC liver metastasis from pancreatic cancer without a squamous cell component in the primary tumor. Evaluation of KRAS mutations in both specimens was useful for diagnosis.
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Affiliation(s)
- Yohei Mano
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
- Department of Surgery, Oita Red Cross Hospital, 3-2-37 Chiyomachi, Oita, 870-0033 Japan
| | - Keishi Sugimachi
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Tomonari Shimagaki
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Takahiro Tomino
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Emi Onishi
- Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Lingaku Lee
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Terumasa Hisano
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Yutaka Koga
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Kenichi Taguchi
- Department of Pathology, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Masaru Morita
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
| | - Yasushi Toh
- Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395 Japan
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3
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Bellefkih FZ, Benchakroun N, Lalya I, Amaoui B, El Kacemi H, Acharki A, El Hfid M, El Mazghi A, Chekrine T, Bouchbika Z, Jouhadi H, Sahraoui S, Tawfiq N, Michalet M. Radiotherapy in the management of rare gastrointestinal cancers: A systematic review. Cancer Radiother 2023; 27:622-637. [PMID: 37500390 DOI: 10.1016/j.canrad.2023.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 06/10/2023] [Accepted: 06/13/2023] [Indexed: 07/29/2023]
Abstract
The aim of this analysis is to assess radiotherapy's role and technical aspects in an array of rare gastrointestinal (GI) cancers for adult patients. Collection data pertaining to radiotherapy and digestive rare cancers were sourced from Medline, EMBASE, and Cochrane Library. Preoperative chemoradiotherapy improved outcomes for patients with esophageal undifferentiated carcinoma compared with esophageal salivary gland types of carcinomas. For rare gastric epithelial carcinoma, perioperative chemotherapy is the common treatment. Adjuvant chemoradiotherapy showed no benefice compared with adjuvant chemotherapy for duodenal adenocarcinoma. Small bowel sarcomas respond well to radiotherapy. By analogy to anal squamous cell carcinoma, exclusive chemoradiotherapy provided better outcomes for patients with rectal squamous cell carcinoma. For anal adenocarcinoma, neoadjuvant chemoradiotherapy, followed by radical surgery, was the most effective regimen. For pancreatic neuroendocrine tumors, chemoradiotherapy can be a suitable option as postoperative or exclusive for unresectable/borderline disease. The stereotactic body radiotherapy (SBRT) is a promising approach for hepatobiliary malignancy. Radiotherapy is a valuable option in gastrointestinal stromal tumors (GIST) for palliative intent, tyrosine kinase inhibitors (TKIs) resistant disease, and unresectable or residual disease. Involved field (IF) radiotherapy for digestive lymphoma provides good results, especially for gastric extranodal marginal zone lymphoma (MALT). In conclusion, radiotherapy is not an uncommon indication in this context. A multidisciplinary approach is needed for better management of digestive rare cancers.
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Affiliation(s)
- F Z Bellefkih
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco.
| | - N Benchakroun
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco; Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - I Lalya
- Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - B Amaoui
- Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - H El Kacemi
- Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - A Acharki
- Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - M El Hfid
- Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - A El Mazghi
- Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - T Chekrine
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco
| | - Z Bouchbika
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco
| | - H Jouhadi
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco
| | - S Sahraoui
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco; Association marocaine d'oncologie-radiothérapie (Aoram), Casablanca, Morocco
| | - N Tawfiq
- Department of Radiotherapy-Oncology, Ibn Rochd University Hospital, Hassan II University, Casablanca, Morocco
| | - M Michalet
- Service d'oncologie-radiothérapie, institut du cancer de Montpellier, Fédération d'oncologie-radiothérapie d'Occitanie Méditerranée (Forom), Montpellier, France
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4
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Choi CCM, Arafat Y, Shamassi M, Choi J. Challenges in managing upper gastrointestinal bleeding secondary to primary squamous cell carcinoma of the pancreas: a case report and literature review. Surg Case Rep 2023; 9:77. [PMID: 37171715 PMCID: PMC10182212 DOI: 10.1186/s40792-023-01663-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Primary pancreatic squamous cell carcinoma (SCC) is a rare type of pancreatic cancer, with an incidence of 5% of all pancreatic cancers. This condition is associated with a poor prognosis, and no optimal treatment has been established (Zhang et al. in Medicine (Baltim). 97:e12253, 2018). CASE PRESENTATION A 56-year-old man presented to our hospital with upper gastrointestinal bleeding and new-onset diabetes mellitus. He had no other medical comorbidities, episodes of pancreatitis and symptoms secondary to pancreatic insufficiency. A computed tomography (CT) scan showed a 94 × 72 × 83 mm necrotic pancreatic body mass with gastric invasion and multiple liver metastases. Gastroscopy revealed deep ulcerations at the posterior wall of the stomach with an active slow ooze. Endoscopic ultrasound was performed with EUS guided biopsy, which confirmed poorly differentiated squamous carcinoma of the pancreas. The patient underwent palliative radiotherapy for recurrent upper gastrointestinal bleeding followed by palliative chemotherapy with gemcitabine and nab-paclitaxel. He was referred to dietitians and diabetes educators for the management of pancreatic exocrine and endocrine insufficiency before being referred to community palliative care upon discharge. CONCLUSIONS This is the first reported Australian case of pancreatic SCC presenting with upper gastrointestinal bleeding and new-onset diabetes mellitus. Patients with unresectable disease require a multidisciplinary approach to manage complications and improve symptom control. However, there are no standard treatment guidelines and future research is needed in this regard.
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Affiliation(s)
- Colin Chan-Min Choi
- Department of Upper Gastrointestinal/Hepatobiliary Surgery, Western Health, Footscray, VIC, Australia.
| | - Yasser Arafat
- Department of Surgery, Western Precinct, University of Melbourne, Melbourne, Australia
- Department of Colorectal and General Surgery, Western Health, Footscray, VIC, Australia
| | - Maryam Shamassi
- Department of Anatomical Pathology, Western Health (Dorevitch Pathology), Footscray, VIC, Australia
| | - Julian Choi
- Department of Upper Gastrointestinal/Hepatobiliary Surgery, Western Health, Footscray, VIC, Australia
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5
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Marak JR, Raj G, Khanna T, Husain N, Gandhi A. Primary squamous cell carcinoma of pancreas in a patient with chronic pancreatitis: A rare case report. Radiol Case Rep 2023; 18:2024-2029. [PMID: 37033687 PMCID: PMC10073614 DOI: 10.1016/j.radcr.2023.02.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 02/13/2023] [Accepted: 02/18/2023] [Indexed: 04/05/2023] Open
Abstract
Primary squamous cell carcinoma of pancreas is a rare malignant neoplasm. It has been reported as case reports only, hence clinical information is limited. Here, we present a case of primary squamous cell carcinoma of pancreas in a 47-year-old female with a background history of chronic pancreatitis. Patient was treated with systemic chemotherapy; however, she did not respond to the treatment protocol. Follow-up CT scan showed increase in the size and extension of the lesion. It is an aggressive tumor and does not respond well to chemotherapy or radiotherapy.
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Affiliation(s)
- James R. Marak
- Department of Radiodiagnosis, Dr RMLIMS, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
- Corresponding author: Gomti Nagar, Lucknow, Uttar Pradesh, Pin No 226010.
| | - Gaurav Raj
- Department of Radiodiagnosis, Dr RMLIMS, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
| | - Tanvi Khanna
- Department of Radiodiagnosis, Dr RMLIMS, Gomti Nagar, Lucknow, Uttar Pradesh, 226010, India
| | - Nuzhat Husain
- Department of Pathology, Dr RMLIMS, Lucknow, Uttar Pradesh, 226010, India
| | - Ajeet Gandhi
- Department of Radiation Oncology, Dr RMLIMS, Lucknow, Uttar Pradesh, 226010, India
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6
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Chao LJ, Chuang YT, Shiao CC, Lai HY. Primary Squamous Cell Carcinoma of the Pancreas From a Large Cyst: A Case Report. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2023; 16:11795476231173250. [PMID: 37197031 PMCID: PMC10184239 DOI: 10.1177/11795476231173250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 04/15/2023] [Indexed: 05/19/2023]
Abstract
Pancreatic squamous cell cancer (PSCC) is a rare and aggressive form of pancreatic cancer that has a poor prognosis. The 5-year survival rate for PSCC is estimated to be approximately 10%, and the median overall survival time is 6 to 12 months. Treatment options for PSCC include surgery, chemotherapy, and radiation therapy, but the outcomes are usually not very favorable. The outcomes depend on the stage of the cancer and the patient's overall health and response to treatment. The optimal management remains early diagnosis and surgical resection. We present a rare case of PSCC with spleen invasion, which arises from a large cyst with eggshell calcification, the patient was treated by surgical resection of the tumor and adjuvant chemotherapy. This case report emphasizes the necessity of regular follow for pancreatic cyst.
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Affiliation(s)
- Ling-Jui Chao
- Department of Gastroenterology, Mennonite Christian Hospital, Hualien
| | - Yi-Ting Chuang
- Department of Medical Education and Research, Mennonite Christian Hospital, Hualien
| | - Chih-Chung Shiao
- Division of Nephrology, Department of Internal Medicine, Camillian Saint Mary’s Hospital Luodong, Yilan
| | - Hsien-Yung Lai
- Department of Medical Education and Research, Mennonite Christian Hospital, Hualien
- Department of Anesthesiology, Mennonite Christian Hospital, Hualien
- Hsien-Yung Lai, Mennonite Christian Hospital, No. 44, Ming-Churn Road, Hualien.
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7
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Ruecker K, Gill P, Marascia D, Loveday BP, Pang JMB. Locally invasive squamous cell carcinoma of the pancreas requiring multivisceral resection. ANZ J Surg 2022; 92:3366-3368. [PMID: 35394104 DOI: 10.1111/ans.17684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 03/21/2022] [Indexed: 12/31/2022]
Affiliation(s)
- Kelly Ruecker
- Department of General Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Patwinder Gill
- Department of General Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Daniel Marascia
- Department of General Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Benjamin Pt Loveday
- Department of General Surgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Department of Surgical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Jia-Min B Pang
- Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
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8
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Okamoto T. Malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer. World J Gastroenterol 2022; 28:985-1008. [PMID: 35431494 PMCID: PMC8968522 DOI: 10.3748/wjg.v28.i10.985] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 07/03/2021] [Accepted: 02/16/2022] [Indexed: 02/06/2023] Open
Abstract
Malignant biliary obstruction generally results from primary malignancies of the pancreatic head, bile duct, gallbladder, liver, and ampulla of Vater. Metastatic lesions from other primaries to these organs or nearby lymph nodes are rarer causes of biliary obstruction. The most common primaries include renal cancer, lung cancer, gastric cancer, colorectal cancer, breast cancer, lymphoma, and melanoma. They may be difficult to differentiate from primary hepato-pancreato-biliary cancer based on imaging studies, or even on biopsy. There is also no consensus on the optimal method of treatment, including the feasibility and effectiveness of endoscopic intervention or surgery. A thorough review of the literature on pancreato-biliary metastases and malignant biliary obstruction due to metastatic non-hepato-pancreato-biliary cancer is presented. The diagnostic modality and clinical characteristics may differ significantly depending on the type of primary cancer. Different primaries also cause malignant biliary obstruction in different ways, including direct invasion, pancreatic or biliary metastasis, hilar lymph node metastasis, liver metastasis, and peritoneal carcinomatosis. Metastasectomy may hold promise for some types of pancreato-biliary metastases. This review aims to elucidate the current knowledge in this area, which has received sparse attention in the past. The aging population, advances in diagnostic imaging, and improved treatment options may lead to an increase in these rare occurrences going forward.
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Affiliation(s)
- Takeshi Okamoto
- Department of Gastroenterology, St. Luke’s International Hospital, Chuo-ku 104-8560, Tokyo, Japan
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9
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Wang Y, Zhou Y, Chen Y, Xia R, Liu J. Epidemiology, Treatment, and Outcome of Pancreatic Squamous Cell Carcinoma and Pancreatic Adenocarcinoma: A Propensity Score-Matching Analysis Based on SEER-Database. Technol Cancer Res Treat 2022; 21:15330338221106533. [PMID: 35770310 PMCID: PMC9251993 DOI: 10.1177/15330338221106533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/20/2022] [Accepted: 05/25/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Pancreatic squamous cell carcinoma (PSCC) is a rare pancreatic malignancy compared to most common pancreatic adenocarcinoma (PAC). Aims: To analyze the prognostics factors of PSCC and compare PAC with PSCC in demographic patterns, clinicopathologic characteristics and treatment modalities. Methods: Data of PSCC and PAC patients from January 1, 2004 to December 31, 2015 were extracted from Surveillance, Epidemiology and End Results (SEER) database for case-control study. Kaplan-Meier method and Cox proportional hazards analysis were used in survival analysis. A 1:3 propensity-score matching (PSM) was performed to compare the overall survival (OS) and cancer specific survival (CSS) between PAC and PSCC in each variable. Results: PAC patients (n = 38 968) and PSCC patients (n = 124) were analyzed. After PSM, 372 PAC patients and 124 PSCC patients were obtained. PSCC tends to happen to elders, white and female with a predilection site of pancreatic head, followed by tail, then body. PSCC have a higher proportion to be poorly differentiated and metastatic when diagnosed. The prognosis of PSCC patients was significantly worse than PAC patients in both univariate and multivariate analyses. Surgery and chemotherapy were independent prognostic factors for PSCC. Conclusions: PSCC patients were identified associated with a worse prognosis than PAC patients. PSCC tend to be poorly differentiated and more easily to be metastatic. Surgery and chemotherapy may be effective therapies to improve the OS of PSCC significantly.
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Affiliation(s)
- Yuqing Wang
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yuwen Zhou
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Yueyun Chen
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Ruolan Xia
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Medicine, Sichuan University, Chengdu, China
| | - Jiyan Liu
- Department of Biotherapy, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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10
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Guo D, Chen C, Lv S, Wu G, Shi W, Li H, Hu H. Management of Primary Squamous Cell Carcinoma of the Pancreas: A Case Report. Front Surg 2021; 8:700229. [PMID: 34765634 PMCID: PMC8575694 DOI: 10.3389/fsurg.2021.700229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Primary squamous cell carcinoma of the pancreas (SCCP) is a rare malignant tumor that has been reported in individual case reports only. The clinical data on primary SCCP treatment are limited. Therefore, the appropriate management strategy for this disease should be standardized. Case Presentation: We present the case of a 63-year-old man admitted to our hospital for upper left abdominal pain for 2 months without weight loss or jaundice. Enhanced computed tomography (CT) and magnetic resonance imaging (MRI) of the abdomen revealed a mixed solid and cystic lesion in the pancreatic tail, measuring 35 × 37 mm in maximum diameter with enhancement. The patient was diagnosed with primary SCCP without metastasis, based on radiological and pathological findings. He did not receive neoadjuvant therapy postoperatively and was followed up by CT and MRI for 18 months without recurrence or metastasis. Result: Complete resection is the most effective treatment for early stage primary SCCP. Abdominal MRI is an effective imaging tool for preoperative evaluation and postoperative follow-up of primary SCCP. The need for neoadjuvant therapy depends on various factors. Conclusion: Primary SCCP is a tumor with poor prognosis. Risk factor control, early accurate radiologic evaluation, and individualized treatment strategies improve the quality of life and prolong the overall survival period of patients.
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Affiliation(s)
- Danling Guo
- Department of Radiology, Shaoxing People's Hospital, Shaoxing, China
| | - Chao Chen
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Sangying Lv
- Department of Radiology, Shaoxing People's Hospital, Shaoxing, China
| | - Guanzuan Wu
- Department of Radiology, Shaoxing People's Hospital, Shaoxing, China
| | - Wei Shi
- Department of Pathology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Huaifeng Li
- Department of Radiology, Shaoxing People's Hospital, Shaoxing, China
| | - Hongjie Hu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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11
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Kim JH, Kang CD, Lee K, Lim KH. Metachronous squamous cell carcinoma of pancreas and stomach in an elderly female patient: A case report. World J Clin Cases 2021; 9:9680-9685. [PMID: 34877306 PMCID: PMC8610886 DOI: 10.12998/wjcc.v9.i31.9680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 08/25/2021] [Accepted: 09/10/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Squamous cell carcinoma (SCC) in pancreas and stomach is a rare histologic subtype with aggressive behavior, poor prognosis, and no standardized therapy. Pancreatic SCC or gastric SCC has been previously reported. However, case of SCC occurring in both the pancreas and the stomach has not been reported yet.
CASE SUMMARY A 75-year-old female with prior history of hypertension and diabetes mellitus visited our hospital with complaint of abdominal pain that started three months ago. Computed tomography (CT) scan of the abdomen showed 3.3 cm mass at the distal pancreas. She received surgical resection which was histologically found to be SCC of the pancreas with clear resection margins. After she was discharged, she no longer visited the hospital. Three years later, she was referred to our hospital after showing abnormal findings on a gastroscopy performed at another hospital. Gastroscopy revealed a single, 2cm sized, ill-defined irregular flat and hyperemic mass at high body. Histologic finding of the mass was SCC. CT scan and positive emission tomography CT showed metastatic lesions to the liver and the peritoneum. She received combination chemotherapy with capecitabine and oxaliplatin. However, she passed away 6 mo after diagnosis of gastric SCC.
CONCLUSION To the best of our knowledge, this is the first case of metachronous SCC of stomach occurring after diagnosis of pancreatic SCC.
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Affiliation(s)
- Ji Hyun Kim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
| | - Chang Don Kang
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
| | - Kyungyul Lee
- Department of Pathology, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
| | - Kyu-Hyoung Lim
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24341, Kangwon Do, South Korea
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12
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Yang B, Ren H, Yu G. Case Report: Squamous Cell Carcinoma of Pancreas With High PD-L1 Expression: A Rare Presentation. Front Oncol 2021; 11:680398. [PMID: 34277425 PMCID: PMC8281219 DOI: 10.3389/fonc.2021.680398] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 05/27/2021] [Indexed: 11/24/2022] Open
Abstract
Primary pancreatic squamous cell carcinoma is sporadic. The diagnosis is usually made following surgery or needle biopsy and requires a thorough workup to exclude metastatic squamous cell carcinoma. Squamous cell carcinoma of the pancreas often has a very poor prognosis. There is no treatment guideline for this type of cancer, and to date, no therapeutic regimen has been proven effective. Here, we report the effectiveness of immunotherapy in combination with chemotherapy against locally advanced squamous cell carcinoma of the pancreas with high programmed cell death ligand 1 (PD-L1) expression. Regional intra-arterial infusion chemotherapy consisting of nab-Paclitaxel followed by gemcitabine infused via gastroduodenal artery every three weeks for two cycles. This therapy resulted in the depletion of carcinoma, and the patient continues to lead a high-quality life with no symptoms for more than 16 months.
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Affiliation(s)
- Baohong Yang
- Oncology Department, Weifang People's Hospital, Weifang Medical University, Weifang, China
| | - Haipeng Ren
- Oncology Department, Weifang People's Hospital, Weifang Medical University, Weifang, China
| | - Guohua Yu
- Oncology Department, Weifang People's Hospital, Weifang Medical University, Weifang, China
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13
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Huang X, Wang C, Ma T, Huang Z, Zhou H, Xu L, Zhang R, Zhao J, Zhang Y, Huang Z, Shao L, Wang Y, Yang F, Che X. The Efficacy of Combined Cisplatin and Nanoparticle Albumin-Bound Paclitaxel in a Stage IV Pancreatic Squamous Cell Carcinoma Patient With a Somatic BRCA2 Mutation: A Case Report. Front Oncol 2021; 11:585983. [PMID: 33996534 PMCID: PMC8116796 DOI: 10.3389/fonc.2021.585983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 04/08/2021] [Indexed: 12/21/2022] Open
Abstract
Pancreatic squamous cell carcinoma (SCC) is a rare primary pancreatic malignancy with a poor prognosis. The median overall survival (OS) for metastatic setting is only 4 months and the optimal management remains poorly defined. In the present study, we report a 52-year-old female patient with stage IV primary SCC of the pancreas harboring a deleteous BRCA2 somatic mutation. After 10 cycles of chemotherapy of cisplatin combined with nanoparticle albumin-bound paclitaxel, metastatic lesions in the liver and lymph nodes achieved radiographic complete responses and pancreatic lesion shrank from 5.7 to 1.5 cm in diameter. The patient subsequently underwent a posterior radical antegrade modular pancreatosplenectomy with R0 resection and residual liver lesions were also resected. After 3 months, a tumor relapsed in the liver. She was then treated with olaparib combined with pembrolizumab and achieved stable disease on the liver lesion. The patient eventually died from cerebral hemorrhage with a long OS of 21 months. Our case demonstrated a favorable clinical activity and survival advantage of the combined cisplatin and nanoparticle albumin-bound paclitaxel, which might serve as a therapeutic option for the patient with BRCA-mutant pancreatic SCC.
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Affiliation(s)
- Xiaozhun Huang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Chunling Wang
- Department of Hospital Acquired Infection Control, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Teng Ma
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Zhangkan Huang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Houhong Zhou
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Lin Xu
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Renjie Zhang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Jianjun Zhao
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Yefan Zhang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Zhen Huang
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Lin Shao
- Department of Medicine, Burning Rock Biotech, Guangzhou, China
| | - Yang Wang
- Department of Medicine, Burning Rock Biotech, Guangzhou, China
| | - Fan Yang
- Department of Medicine, Burning Rock Biotech, Guangzhou, China
| | - Xu Che
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital and Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Gastrointestinal and Pancreatic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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14
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Farokhi P, Sadeghi A, Moghaddas A, Heidarpour M, Dinari S. Primary Squamous Cell Carcinoma, a Rare Pathological Report of Pancreatic Cancer. CASPIAN JOURNAL OF INTERNAL MEDICINE 2021; 12:S407-S412. [PMID: 34760094 PMCID: PMC8559630 DOI: 10.22088/cjim.12.0.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 09/02/2020] [Accepted: 10/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Primary squamous cell carcinoma (SCC) of the pancreas is a rare tumor and associated with poor prognosis. The diagnosis and optimal management of patients is still a matter of debate and not well-defined. Limited chemotherapy protocols, radiotherapy and surgical resection of the tumor were proposed for the management of patients suffering from SCC of the pancreas. CASE PRESENTATION In this report, we introduced a 57-year-old man who was diagnosed with SCC of the pancreas along with liver metastasis. The patient underwent surgical resection and several adjuvant systemic chemotherapies including fluorouracil and taxane based regimens which were led to the 13- month overall survival. CONCLUSION Although, the patients died from underlying tumor, the survival time before death was one of the longest time/period reported.
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Affiliation(s)
- Pegah Farokhi
- Department of Clinical Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Sadeghi
- Department of Internal Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Moghaddas
- Department of Clinical Pharmacy, Faculty of Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mitra Heidarpour
- Department of Pathology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saman Dinari
- Department of Clinical Pharmacy, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Yi M, Tan Y, Wang L, Cai J, Li X, Zeng Z, Xiong W, Li G, Li X, Tan P, Xiang B. TP63 links chromatin remodeling and enhancer reprogramming to epidermal differentiation and squamous cell carcinoma development. Cell Mol Life Sci 2020; 77:4325-4346. [PMID: 32447427 PMCID: PMC7588389 DOI: 10.1007/s00018-020-03539-2] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 02/21/2020] [Accepted: 04/24/2020] [Indexed: 12/19/2022]
Abstract
Squamous cell carcinoma (SCC) is an aggressive malignancy that can originate from various organs. TP63 is a master regulator that plays an essential role in epidermal differentiation. It is also a lineage-dependent oncogene in SCC. ΔNp63α is the prominent isoform of TP63 expressed in epidermal cells and SCC, and overexpression promotes SCC development through a variety of mechanisms. Recently, ΔNp63α was highlighted to act as an epidermal-specific pioneer factor that binds closed chromatin and enhances chromatin accessibility at epidermal enhancers. ΔNp63α coordinates chromatin-remodeling enzymes to orchestrate the tissue-specific enhancer landscape and three-dimensional high-order architecture of chromatin. Moreover, ΔNp63α establishes squamous-like enhancer landscapes to drive oncogenic target expression during SCC development. Importantly, ΔNp63α acts as an upstream regulator of super enhancers to activate a number of oncogenic transcripts linked to poor prognosis in SCC. Mechanistically, ΔNp63α activates genes transcription through physically interacting with a number of epigenetic modulators to establish enhancers and enhance chromatin accessibility. In contrast, ΔNp63α also represses gene transcription via interacting with repressive epigenetic regulators. ΔNp63α expression is regulated at multiple levels, including transcriptional, post-transcriptional, and post-translational levels. In this review, we summarize recent advances of p63 in epigenomic and transcriptional control, as well as the mechanistic regulation of p63.
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Affiliation(s)
- Mei Yi
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Yixin Tan
- Department of Dermatology, The Second Xiangya Hospital, The Central South University, Changsha, 410011, Hunan, China
| | - Li Wang
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Jing Cai
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Xiaoling Li
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Zhaoyang Zeng
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Wei Xiong
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Guiyuan Li
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China
| | - Xiayu Li
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
| | - Pingqing Tan
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China.
- Department of Head and Neck Surgery, Hunan Provincial Cancer Hospital and Cancer Hospital Affiliated to Xiangya Medical School, Central South University, Changsha, 410013, Hunan, China.
| | - Bo Xiang
- NHC Key Laboratory of Carcinogenesis, Hunan Provincial Cancer Hospital and the Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, Hunan, China.
- Hunan Key Laboratory of Nonresolving Inflammation and Cancer, The Third Xiangya Hospital, Central South University, Changsha, 410013, Hunan, China.
- The Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute and School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China.
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16
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Niger M, Prisciandaro M, Antista M, Monica MAT, Cattaneo L, Prinzi N, Manglaviti S, Nichetti F, Brambilla M, Torchio M, Corti F, Pusceddu S, Coppa J, Mazzaferro V, de Braud F, Di Bartolomeo M. One size does not fit all for pancreatic cancers: A review on rare histologies and therapeutic approaches. World J Gastrointest Oncol 2020; 12:833-849. [PMID: 32879662 PMCID: PMC7443847 DOI: 10.4251/wjgo.v12.i8.833] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/01/2020] [Accepted: 05/20/2020] [Indexed: 02/05/2023] Open
Abstract
Exocrine pancreatic neoplasms represent up to 95% of pancreatic cancers (PCs) and are widely recognized among the most lethal solid cancers, with a very poor 5-year survival rate of 5%-10%. The remaining < 5% of PCs are neuroendocrine tumors that are usually characterized by a better prognosis, with a median overall survival of 3.6 years. The most common type of PC is pancreatic ductal adenocarcinoma (PDAC), which accounts for roughly 85% of all exocrine PCs. However up to 10% of exocrine PCs have rare histotypes, which are still poorly understood. These subtypes can be distinguished from PDAC in terms of pathology, imaging, clinical presentation and prognosis. Additionally, due to their rarity, any knowledge regarding these specific histotypes is mostly based on case reports and a small series of retrospective analyses. Therefore, treatment strategies are generally deduced from those used for PDAC, even if these patients are often excluded or not clearly represented in clinical trials for PDAC. For these reasons, it is essential to collect as much information as possible on the management of PC, as assimilating it with PDAC may lead to the potential mistreatment of these patients. Here, we report the most significant literature regarding the epidemiology, typical presentation, possible treatment strategies, and prognosis of the most relevant histotypes among rare PCs.
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Affiliation(s)
- Monica Niger
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Michele Prisciandaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Maria Antista
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Melissa Anna Teresa Monica
- First Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Laura Cattaneo
- First Pathology Division, Department of Pathology and Laboratory Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Natalie Prinzi
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Sara Manglaviti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Federico Nichetti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Marta Brambilla
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Martina Torchio
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Francesca Corti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Sara Pusceddu
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Jorgelina Coppa
- Hepato-biliary-pancreatic Surgery and Liver Transplantation Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
| | - Vincenzo Mazzaferro
- Hepato-biliary-pancreatic Surgery and Liver Transplantation Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
- Università degli studi di Milano, Milan 20133, Italy
| | - Filippo de Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
- Università degli studi di Milano, Milan 20133, Italy
| | - Maria Di Bartolomeo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan 20133, Italy
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17
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Gruhl JD, Garrido-Laguna I, Francis SR, Affolter K, Tao R, Lloyd S. The impact of squamous cell carcinoma histology on outcomes in nonmetastatic pancreatic cancer. Cancer Med 2020; 9:1703-1711. [PMID: 31945808 PMCID: PMC7050091 DOI: 10.1002/cam4.2851] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 11/12/2019] [Accepted: 12/12/2019] [Indexed: 12/31/2022] Open
Abstract
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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Affiliation(s)
- Joshua D Gruhl
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
| | - Ignacio Garrido-Laguna
- Department of Internal Medicine, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
| | - Samual R Francis
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
| | - Kajsa Affolter
- Department of Anatomic Pathology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
| | - Randa Tao
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
| | - Shane Lloyd
- Department of Radiation Oncology, Huntsman Cancer Hospital, University of Utah, Salt Lake City, UT, USA
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18
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Taibi A, Jacques J, Durand Fontanier S, Charissoux A, Bardet SM, Christou N, Fredon F, Valleix D, Mathonnet M. Long-term survival after surgery of pancreatic primary squamous cell carcinoma: A case report and literature review. Clin Case Rep 2019; 7:2092-2101. [PMID: 31788258 PMCID: PMC6878063 DOI: 10.1002/ccr3.2429] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2019] [Revised: 08/12/2019] [Accepted: 08/17/2019] [Indexed: 12/15/2022] Open
Abstract
Pancreatic primary squamous cell carcinoma is rarer and no optimal treatment has been validated according to the tumor stage. The surgical resection was the only curative option. The radiotherapy or chemotherapy was performed for the other cases.
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Affiliation(s)
- Abdelkader Taibi
- Digestive Surgery DepartmentDupuytren University HospitalLimogesFrance
- CNRSXLIMUMR 7252University LimogesLimogesFrance
| | - Jeremie Jacques
- CNRSXLIMUMR 7252University LimogesLimogesFrance
- Gastroenterology DepartmentDupuytren University HospitalLimogesFrance
| | - Sylvaine Durand Fontanier
- Digestive Surgery DepartmentDupuytren University HospitalLimogesFrance
- CNRSXLIMUMR 7252University LimogesLimogesFrance
| | | | | | - Niki Christou
- Digestive Surgery DepartmentDupuytren University HospitalLimogesFrance
| | - Fabien Fredon
- Digestive Surgery DepartmentDupuytren University HospitalLimogesFrance
| | - Denis Valleix
- Digestive Surgery DepartmentDupuytren University HospitalLimogesFrance
| | - Muriel Mathonnet
- Digestive Surgery DepartmentDupuytren University HospitalLimogesFrance
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19
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Sydney GI, Ioakim KJ, Sergentanis TN, Tsiotos GG, Kyriakidou V, Sepsa A, Theocharis S, Salla C, Nikas I. Dissecting the presence of malignant squamous cells in pancreatic cytopathology: A case series. Diagn Cytopathol 2019; 47:1287-1292. [PMID: 31407529 DOI: 10.1002/dc.24302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 07/24/2019] [Accepted: 08/01/2019] [Indexed: 12/13/2022]
Abstract
The presence of malignant squamous cells in pancreatic cytopathology is a rare phenomenon that results either from a primary or a metastatic process. Pancreatic adenosquamous carcinoma (PASC) represents the most common variant of pancreatic ductal adenocarcinoma and is associated with a dismal prognosis. Within the period of 2013-2018, the archives of "Hygeia and Mitera Hospital" were searched for pancreatic cytopathology-related diagnoses that included the interpretation of "malignant squamous cells present." All fine needle aspirations (FNAs) of pancreatic lesions, including liver metastases in patients with known pancreatic primaries, were retrieved along with their relevant clinical information. Five pancreatic and two liver FNAs acquired from a total of six patients were reexamined. None of these patients had any documented history of primary squamous malignancy elsewhere. All pancreatic and one of the two liver FNAs showed malignant squamous cells, identified based on either morphology or immunochemistry. The other liver FNA represented a metastatic deposit which comprised of only a glandular component, whereas the associated pancreatic FNA exhibited both squamous and glandular counterparts. Most cases characteristically showed necrosis and keratinization. Of interest, two cases revealed the presence of tumor-associated giant cells. In conclusion, the presence of malignant squamous cells in pancreatic FNAs could mean the presence of PASC, especially when there is no documented history of a primary malignancy and a complete clinical and imaging workup has been performed. Immunochemistry on cell block material could help to confirm squamous differentiation in the absence of overt keratinization.
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Affiliation(s)
- Guy I Sydney
- School of Medicine, European University Cyprus, Nicosia, Cyprus
| | | | - Theodoros N Sergentanis
- Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | - Athanasia Sepsa
- First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Stamatios Theocharis
- First Department of Pathology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Charitini Salla
- Department of Cytopathology, Hygeia & Mitera Hospital, Athens, Greece
| | - Ilias Nikas
- School of Medicine, European University Cyprus, Nicosia, Cyprus
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20
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Natural History and Treatment Trends in Pancreatic Cancer Subtypes. J Gastrointest Surg 2019; 23:768-778. [PMID: 30706376 DOI: 10.1007/s11605-019-04113-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/07/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND While pancreatic ductal adenocarcinoma is the most common form of pancreatic cancer, many other histologic forms of pancreatic cancer are also recognized. These histologic variants portray unique characteristics in terms of patient demographics, tumor behavior, survival, and responsiveness to treatments. MATERIALS AND METHODS Patients who underwent surgical resection of the pancreas for non-metastatic, invasive pancreatic cancer between 2004 and 2014 were selected from the National Cancer Data Base and categorized by histologic variant according to WHO classification guidelines. Patient demographics, tumor variables, treatment characteristics, and survival were compared between histologic groups and subgroups. RESULTS A total of 57,804 patients met inclusion and exclusion criteria and were grouped into eight major histologic categories. Survival analysis by the histologic group showed median overall survival of 20.2 months for ductal adenocarcinoma, 20.5 months for squamous cell carcinoma, 26.8 months for mixed acinar-neuroendocrine carcinomas, 52.6 months for cystic mucinous neoplasms with an associated invasive carcinoma, 67.5 months for acinar cell carcinoma, and 69.3 months for mesenchymal tumors. Median survival was not reached for neuroendocrine tumors and solid-pseudopapillary neoplasms, with 5-year overall survival rates of 84% and 97% respectively. CONCLUSIONS Rare subtypes of pancreatic cancer present unique clinicopathologic characteristics and display distinct tumor biologies. This study presents data on demographic, prognostic, treatment, and survival outcomes between rare forms of pancreatic neoplasms in order to aid understanding of the natural history and behavior of these neoplasms, with the hope of serving as a reference in clinical decision-making and ability to provide accurate prognostic information to patients.
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21
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Kumar Das Majumdar S, Kumar Muduly D, Mishra S, Mohapatra CRR, Bunger D, Khan MA. Management of primary squamous cell carcinoma of the pancreas with a nanosomal paclitaxel lipid suspension-based regimen: A case report. Mol Clin Oncol 2019; 10:430-434. [PMID: 30931112 PMCID: PMC6425502 DOI: 10.3892/mco.2019.1814] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/01/2019] [Indexed: 01/05/2023] Open
Abstract
Squamous cell carcinoma (SCC) of the pancreas is a rare tumor with only a few case reports available. It is an aggressive form of pancreatic cancer with a poor prognosis. The diagnosis and optimal management of SCC of the pancreas is poorly defined due to the lack of standard treatment or guidelines and owing to the rarity of this malignancy. Patients suffering from SCC of the pancreas do not respond well to chemotherapy or radiotherapy and isolated reports are available on the use of gemcitabine and newer taxane formulations. Surgical resection of the tumor is the most effective modality; however, due to a delay in diagnosis, the majority of pancreatic SCCs remain unresectable. Herein, a case of SCC of the pancreatic tail is reported in a 60-year-old patient who was managed with a combination of albumin-free nanosomal paclitaxel lipid suspension (NPLS) and gemcitabine in a neoadjuvant setting. To the best of our knowledge, this is the first such case report of a locally advanced SCC of the pancreatic tail showing an overall survival of 1 year following treatment with an NPLS based regimen. The treatment was well tolerated with no serious safety concerns.
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Affiliation(s)
- Saroj Kumar Das Majumdar
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India
| | - Dillip Kumar Muduly
- Department of Surgical Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India
| | - Subhasis Mishra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019, India
| | | | - Deepak Bunger
- Department of Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380054, India
| | - Mujtaba A Khan
- Department of Medical Affairs and Clinical Development, Intas Pharmaceuticals Ltd., Ahmedabad, Gujarat 380054, India
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Wang J, Shen J, Zhao K, Hu J, Dong J, Sun J. STIM1 overexpression in hypoxia microenvironment contributes to pancreatic carcinoma progression. Cancer Biol Med 2019; 16:100-108. [PMID: 31119050 PMCID: PMC6528447 DOI: 10.20892/j.issn.2095-3941.2018.0304] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Stromal interaction molecule 1 (STIM1) overexpression has been reported to play an important role in progression of several cancers. However, the mechanism of STIM1 overexpression and its relationship with hypoxia in pancreatic ductal adenocarcinoma (PDAC) remains unclear. Methods STIM1 and HIF-1α expression was tested using immunohistochemistry in tissue microarray (TMA) including pancreatic cancer and matched normal pancreatic tissues, and their relationships with clinicopathological parameters were statistically analyzed. q-PCR, Western blot, ChIP, and luciferase assay were employed to 030 analyze transcriptional regulation between HIF-1α and STIM1 in pancreatic cancer PANC-1 cells. Results Both STIM1 and HIF-1α showed higher positive rates and up-regulated expression in cancer tissues compared to that of normal tissues (P < 0.05). The Kaplan–Meier method revealed that higher HIF-1α and STIM1 expression levels were significantly correlated with decreased disease-free survival ( P = 0.025 and P = 0.029, respectively). The expression of HIF-1α showed a significant positive correlation with that of STIM1 in cancer tissues (rs = 0.3343, P = 0.0011) and pancreatic cancer cell lines. Furthermore, ChIP and luciferase assays confirmed that HIF-1α bound to the STIM1 promoter and regulated its expression in PANC-1 cells.
Conclusions In hypoxia microenvironment, up-regulated expression of STIM1 mediated by HIF-1α promotes PDAC progression. HIF-1α and STIM1 are potential prognostic markers and/or therapeutic targets for PDAC treatment.
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Affiliation(s)
- Jian Wang
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Junling Shen
- State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, Yunnan University, Kunming 650091, China
| | - Kaili Zhao
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Jinmeng Hu
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Jiuxing Dong
- Department of Pancreatic Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China
| | - Jianwei Sun
- State Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan, Center for Life Sciences, School of Life Sciences, Yunnan University, Kunming 650091, China
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Wahab A, Gonzalez JJ, Devarkonda V, Saint–Phard T, Singh T, Adekolujo OS. Squamous cell carcinoma-A rare pancreatic exocrine malignancy. Cancer Biol Ther 2018; 20:593-596. [PMID: 30388929 PMCID: PMC6606028 DOI: 10.1080/15384047.2018.1539291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 10/01/2018] [Accepted: 10/17/2018] [Indexed: 10/27/2022] Open
Abstract
A 65-year-old Caucasian female presented with abdominal symptoms and obstructive jaundice. She reported a significant pancreatic cancer history in her family. Her CT of the abdomen and pelvis showed 3.9 × 3.5 cm centrally necrotic mass within the pancreatic head, occluding the superior mesenteric and splenic veins; peripancreatic lymph nodes were enlarged, and there were many hepatic lesions. She underwent biopsy of the hepatic lesions showing metastatic tumor cells, arranged in the form of nests, with enlarged and hyperchromatic irregular nuclei with some nucleoli and moderate eosinophilic cytoplasm. Immunohistochemical staining on cancer cells was positive for CK7, P40, GATA3. These findings were concerning for poorly differentiated metastatic squamous cell carcinoma (SCC). PET-CT showed no other hypermetabolic lesions, suggestive of another primary except pancreatic head with SUV of 17.8, hepatic metastasis and 1 cm right retroperitoneal lymph node. The patient was diagnosed with metastatic SCC of the pancreas. Contrary to the well-known genetic mutations of pancreatic adenocarcinoma, the data on pancreatic SCC-related mutations is limited; however, one such mutation is BRCA-2 exon 15 germline mutation reported in a locally advanced SCC of the pancreas. The index patient is one of those rare cases in which a significant family history of pancreatic cancer was reported. We believe that some familial mutation could be responsible for this finding, i.e., occurrence of pancreatic cancer in multiple family members. Further research is necessary to explore such association.
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Affiliation(s)
- Ahsan Wahab
- Internal Medicine Department, McLaren Regional Medical Center, Flint, MI, USA
| | - Juan Jose Gonzalez
- Internal Medicine Department, McLaren Regional Medical Center, Flint, MI, USA
| | - Vishal Devarkonda
- Internal Medicine Department, McLaren Regional Medical Center, Flint, MI, USA
| | | | - Trevor Singh
- Internal Medicine Department, McLaren Regional Medical Center, Flint, MI, USA
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Zhang G, Cheng ZZ, Xu GH, Jiang X, Wang XX, Wang QF. Primary squamous cell carcinoma of the pancreas with effective comprehensive treatment: A case report and literature review. Medicine (Baltimore) 2018; 97:e12253. [PMID: 30313026 PMCID: PMC6203578 DOI: 10.1097/md.0000000000012253] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
RATIONALE Primary squamous cell carcinoma (SCC) of the pancreas is a rare entity since the pancreas lacks squamous cells. This condition is associated with a poor prognosis, and there is currently no optimal treatment strategy for it. PATIENT CONCERNS A 64-year-old female patient with a complaint of epigastric pain for 3 months was referred to our hospital. DIAGNOSES She was finally diagnosed with primary SCC of the pancreas with lymph node metastasis on the basis of radiological and pathological findings. INTERVENTIONS She received chemoradiation along with targeted therapy and was provided with treatment response evaluation through PET/CT. OUTCOMES She eventually died of tumor progression after 8 months. LESSONS Primary SCC of the pancreas is associated with a poor prognosis. Comprehensive therapy and proper radiologic evaluation may facilitate prolonged survival of these patients.
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Affiliation(s)
| | | | | | | | | | - Qi-feng Wang
- Department of Radiation Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
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