Primary adenosquamous carcinoma of the stomach.A case report and review

Abstract

The occurrence of a neoplasm of a cell type different from that found in the normal organ is always of considerable interest. Eighty‐five cases of either pure squamous cell carcinoma or adenosquamous cell carcinoma of the stomach have been reported to date with an incidence calculated in different series between 0.04 and 0.7%. Its sex ratio is 4:1 in favor of men. The theories of the pathogenesis of such tumors with unexpected cell types have been reviewed. To the authors, prior squamous cell metaplasia of the gastric mucosa seems essential for the pathogenesis of the pure type of this unusual neoplasm, but, in the mixed tumor, either squamous differentiation in an adenocarcinoma or in a cell capable of differentiating along both cell types appears more likely. An additional case of the mixed type is added to the literature.

Primary Pure Squamous Cell Carcinoma Originating from the Stomach

“…The pathogenesis of the gastric SCC remains obscure, but several theories have been suggested as follows: First, tumor growth in area of ectopic squamous cell nest [12][13][14] ; Second, tumor growth in squamous metaplasia of glandular epithelium 15,16 ; Third, pre-existing adenocarcinoma that undergoes squamous differentiation 8,17 ; Fourth, tumor from toti-potential undifferentiated cell. 18 In this case, the 3rd theory can be excluded because no evidence of adenocarcinoma was found out on the pathological result.…”

Primary Squamous Cell Carcinoma of the Stomach: A Case Report.

“…Other theories including squamous differentiation from nests of ectopic squamous cells in gastric mucosa, preexisting adenocarcinoma, totipotential stem cells in the gastric mucosa and gastric vascular endothelial cells have not been proved. 1 Gastric squamous metaplasia may develop due to extrinsic and intrinsic damage, such as corrosive gastric acid burns, luetic linitis plastica, in foci of chronic inflammation in Menetrier disease, after chemotherapy for well-differentiated lymphocytic lymphoma and long period cyclophosphamide therapy. 6 Our patient did not have any known risk factor for developing of PSCCS.…”

“…The only potential curative treatment approach is surgery in localized disease. 1,3,5 Addition of adjuvant polychemotherapy to radical surgical intervention provides the best overall survival. 2,7,9 There is no standard chemotherapy in advanced and metastatic disease.…”

Variants of Gastric Carcinoma: Morphologic and Theranostic Importance

“…The origin of primary squamous carcinoma of the stomach is unclear, but four hypotheses concerning its development have been proposed, including (1) nests of ectopic squamous cells in gastric mucosa; (2) squamous metaplasia of the gastric mucosa before malignant transformation; (3) squamous differentiation in a preexisting adenocarcinoma; and (4) multipotential stem cells in the gastric mucosa [110][111][112].…”