Primary Squamous Cell Carcinoma of Liver

Abstract

Primary squamous cell carcinoma (SCC) of liver is rare, and its prognosis is extremely poor. This study aims at reviewing the clinical data of all pathologically diagnosed liver cancer in our institute, and discussing the clinical presentation, diagnosis, treatment, and prognosis of our cases of SCC and the literatures reported previously.All the patients undergoing liver surgery or biopsy for liver cancers from 2002 to 2013 in our hospital were reviewed, and the liver specimens were examined pathologically. A literature search for case reports of primary SCC of liver published until December 31, 2014, was performed on PubMed, MEDLINE, Scopus Elsevier, Cochrane, and Google Scholar. The primitive data of the case reports were all included and analyzed if available.From January 2002 to October 2013, 2210 cases of liver cancer were diagnosed pathologically in our hospital. Among, 4 cases (0.2%) were diagnosed as primary SCC of liver. All were negative for hepatitis B infection, but present with liver cyst and/or hepatolithiasis. One patient underwent radical resection, but died of tumor recurrence 18 months postoperatively. One patient received transcatheter arterial chemoembolization and 1 patient received laparotomy and alcohol injection, but died 9 and 4 months after surgery, respectively. The last patient received only biopsy and supportive treatment, and finally died of tumor metastasis 6 months later. From 1970 to 2014, 31 cases of primary liver SCC have been published in English previously. Thirty one cases and the 4 cases in the present study were included. The average age of the patients were 54 years (range 18–83), with a male to female ratio of 19:16. Twenty patients had liver cysts, 7 had bile duct stones, and 2 cases had both. Patients undergoing radical surgery had better prognosis than those undergoing palliative treatments (median survival 17 vs 5 months, P = 0.005, log-rank test). Patients with liver cysts seemed to have worse prognosis than those with bile duct stones (median survival 7 vs 18 months, P = 0.090, log-rank test).Primary liver SCC seems to be mostly originated from liver cyst or hepatolithiasis. Radical surgery should be firstly recommended, although the prognosis might be unfavorable.

Metastatic Squamous Cell Carcinoma in the Gallbladder Fossa Complicated by a Duodenal Fistula

“…While the exact pathogenesis of hepatobiliary SCC is unknown, it is assumed that chronic inflammation of the biliary epithelium may promote squamous metaplasia and subsequent dysplasia and malignant transformation [10]. Predisposing conditions to hepatobiliary SCCs may thus be primary sclerosing cholangitis, parasitic liver fluke infection, and recurrent cholangitis.…”

“…A second theory is the presence of heterotropic squamous epithelium, which may explain cases with no history of chronic inflammation [6]. Regardless of their etiology, primary gallbladder, biliary, and hepatic SCCs present at an advanced stage and have a poor prognosis [10][11][12].…”

Primary Intrahepatic Squamous Cell Carcinoma with Histological Collision of Adenocarcinoma and Squamous Cell Carcinoma: A Case Report

“…Patients with primary IHSCC have an extremely poor prognosis, even after extensive surgery of liver tumors to achieve radical resection [ 24 ]. Among the 12 reported cases undergoing curative surgical resection, 7 cases, including the present case, survived over 1 year.…”

Primary intrahepatic squamous cell carcinoma in a sika deer

“…Primary squamous cell carcinoma (SCC) of the liver is rare and has only been sporadically reported in humans [3,5,7,8]. In the World Health Organization (WHO) classification of tumors of the liver and intrahepatic bile ducts (IHBDs) in humans, SCC is described as one of the histological variants of intrahepatic cholangiocarcinoma [4].…”

“…In humans, primary SCC of the liver has been reported to occur in association with chronic inflammation of the bile duct, congenital cysts of the biliary tract, or liver cysts associated with infections and/or stones [5,7,8]. Squamous metaplasia followed by neoplastic transformation of the biliary epithelium under chronic inflammation has been proposed as a potential pathogenetic mechanism for hepatic SCC, but this remains to be confirmed [5,8]. In the current deer, the hepatic SCC transitioned into the hyperplastic and chronically inflamed biliary epithelium of the IHBD showing Fasciola infection.…”