Primary squamous cell carcinoma of the liver: a case report

Abstract

Primary squamous cell carcinoma of the liver is extremely rare, very difficult to diagnose, and carries an extremely poor prognosis. In this study, we discuss the imaging features of a patient with primary hepatic squamous cell carcinoma. The patient was admitted to hospital owing to discomfort in the right upper abdominal quadrant and a loss of appetite. He had no previous risk factors associated with hepatic squamous cell carcinoma and no history of systemic squamous cell carcinoma. We diagnosed primary hepatic squamous cell carcinoma by pathological analysis. Primary hepatic squamous cell carcinoma is rare, and its histological features are controversial, which makes the clinical and imaging diagnosis difficult. Therefore, it is urgent to improve the understanding of this disease in clinical practice to avoid misdiagnosis, and to identify the best treatment. This case provides a basis for the clinical diagnosis of primary hepatic squamous cell carcinoma.

Diagnostic value of imaging modalities in primary squamous cell carcinoma of the liver

“…Enhanced CT findings are as follows (Table 1): (1) slight delayed enhancement at the edge of the lesion, but no enhancement at the center of the lesion in the three phases 9,10,12,19 . (2) Mild enhancement in the focal center and margin in the arterial phase, and continuous enhancement in the focal center and margin in the portal venous and delayed phases, although the density of the lesion after enhancement was still lower than that of the liver parenchyma 5,20,21 . However, in a study by Lee et al, 13 enhanced CT demonstrated a delayed filling enhancement mode, similar to cholangiocarcinoma.…”

“…9,10,12,19 (2) Mild enhancement in the focal center and margin in the arterial phase, and continuous enhancement in the focal center and margin in the portal venous and delayed phases, although the density of the lesion after enhancement was still lower than that of the liver parenchyma. 5,20,21 However, in a study by Lee et al, 13 enhanced CT demonstrated a delayed filling enhancement mode, similar to cholangiocarcinoma. The authors believed that it might be related to the formation of new large vessels in the center of the lesion, leading to inconsistent manifestations.…”

“…The PET/CT manifestations of PSCCL are rounded and heterogeneous low‐density mass shadows. Additionally, the metabolism of 18F‐fluorodeoxyglucose (FDG) is increased significantly 20,22,25,26 . In some studies, 20,22,25 the maximum standardized uptake value of 18F‐FDG was 11.6–21.9 (Table 1).…”

“…(Figure8B);(2) enhanced CT can show annular enhancement of the lesion, but the difference lies in that a liver abscess shows annular enhancement of the inner wall of the abscess, surrounded by low-density bands20 (Figure8C); and (3) MRI of liver abscess usually shows an "annular zone," that is, the T2-weighted signal of the abscess wall is slightly higher than that of the abscess cavity but lower than that of the liver parenchyma, which is different from the MRI features of PSCCL.28F I G U R E 8 Typical imaging images of liver abscess. (A) Typical two-dimensional ultrasound image of liver abscess: In the right lobe of the liver, there was a mixed echo mainly of liquid, with multiple compartments and poor sound transmission in the liquid part.…”

Primary squamous cell carcinoma of liver. First case report from Pakistan and South Asia

“…Generally squamous cell carcinoma is common type of skin cancer which occurs in the squamous cells of the skin which makes the middle and outer layers of the skin [1] . Primary squamous cell carcinoma (PSCC) is a rare primary tumor of the liver.…”