Gastric and duodenal squamous cell carcinoma: metastatic or primary?

Abstract

Either metastatic or primary squamous cell carcinoma in the gastrointestinal tract is extremely rare, with very few cases reported in the literature. In this paper, we report a case in which the patient presented with dysphagia during the course of radiotherapy for recurrent lung cancer in a mediastinal lymph node. Although the dysphagia mimicked radiation esophagitis, the ultimate cause proved to be gastric and duodenal metastases from primary lung squamous cell carcinoma. Taking into account the value of identification of metastatic or primary SCC in the stomach and duodenum on the prognosis and treatment options, it is imperative that the correct diagnosis be established. This report is followed by a discussion of the differential diagnosis between metastatic and primary squamous cell carcinoma in the stomach and duodenum.

Duodenal metastasis from lung adenocarcinoma: A rare cause of melena

“…However, most of cases require duodenectomy or pancreatico-duodenectomy for symptomatic relief [6–10] . Endoscopic resection of smaller duodenal metastatic lesions (≤1 cm) appears to be safe and effective, especially in cases in which these metastases may be removed completely by endoscopic methods, as seen in our patient [11–15] . The role of radiation therapy needs to be investigated, as only case report utilizing radiation therapy for duodenal metastasis has been reported [16] .…”

“…Duodenal involvement as delayed site of distant metastasis or as initial manifestation of primary lung carcinoma is extremely rare. Signs and symptoms depend on the anatomic site of duodenal involvement Table 1 [6–16] .…”

A Rare Presentation of Poorly Differentiated Lung Carcinoma with Duodenal Metastasis and Literature Review

“…Other theories revolve around direct invasion of tumor cells or intraperitoneal dissemination [17,18]. Moreover, several hypotheses on the origin of SCC in the duodenum have been suggested, including isolated ectopic squamous cells, transformation of basal cells into squamous cells, chronic mucosal insults leading to squamous metaplasia, and multipotent stem cells in the GI mucosa [10,[17][18][19].…”

Pure Squamous Cell Carcinoma of the Duodenum

“…Pathogenetic differences between metastatic and primary tumors are also helpful for the clinicians in the differential diagnosis. Many different hypotheses have been demonstrated for elucidation of the pathogenesis of SCC cases detected in the stomach and duodenum such as nests of ectopic squamous cells, the proliferation of uncommitted mucosal basal cells into squamous cells, squamous metaplasia secondary to chronic mucosal damage, squamous differentiation in a preexisting adenocarcinoma, and multipotent stem cells in the gastrointestinal mucosa [ 10 ]. Our case supports the literature by the development of SCC from the ectopic mucosa of the duodenal diverticulum.…”