pancreatic squamous cell carcinoma

Pancreatic Squamous Cell Carcinoma (PSCC): A Rare and Poorly Understood Cancer

Pancreatic squamous cell carcinoma is a rare subtype of pancreatic cancer that originates from the ductal cells of the pancreas. It is characterized by its aggressive behavior and poor prognosis.

• Incidence: PSCC accounts for an estimated 0.5-5% of all pancreatic ductal malignancies [4].
• Symptoms: The prominent features of PSCC are similar to those of ductal adenocarcinoma, including upper abdominal and back pain, anorexia, weight loss, nausea, fatigue, and jaundice [2].
• Histology: Histologically, PSCC is characterized by the presence of keratinization and/or intracellular bridges, which are indicative of squamous cell differentiation [8].

Management and Prognosis

Due to its rarity, there is limited clinical information available on the management and prognosis of PSCC. However, it has been reported that a nanosomal paclitaxel lipid suspension-based regimen may be effective in managing this condition [3].

• Prognosis: Unfortunately, PSCC is associated with a poor prognosis, likely due to its aggressive nature and late presentation [7].

References

[1] A Al-Shehri (2008) - Cited by 66 [2] SH Abedi (2017) - Cited by 17 [3] S Kumar Das Majumdar (2019) - Cited by 10 [4] JA Ford (2023) - Cited by 2 [5] WX Qin (2021) - Cited by 7 [6] JR Marak (2023) - Cited by 1 [7] G Zhang (2018) - Cited by 17 [8] D Guo (2021) - Cited by 4

Common Signs and Symptoms of Pancreatic Squamous Cell Carcinoma

Pancreatic squamous cell carcinoma (SCC) is a rare type of cancer that affects the pancreas. The symptoms of this disease can be similar to those of other types of pancreatic cancer, but there are some specific signs and symptoms that are associated with SCC.

Upper Abdominal and Back Pain Pain in the upper abdomen and back is one of the most common symptoms of pancreatic SCC (1). This pain can range from mild to severe and may worsen over time.

Weight Loss and Fatigue Many patients with pancreatic SCC experience significant weight loss and fatigue (2, 3). These symptoms are often accompanied by a decrease in appetite and an increase in nausea.

Skin Rashes and Joint Pain Some patients may develop skin rashes and joint pain due to the increased levels of enzymes associated with this disease (1).

Other Symptoms

• Jaundice: Yellowish skin and eyes, dark urine, pale bowel motions, and itchy skin are signs of jaundice, which can occur in some cases of pancreatic SCC (4).
• Indigestion, nausea, and vomiting
• Extreme fatigue that does not improve
• Pale stools with or without blood

Skin Lesions In addition to the above symptoms, patients with pancreatic SCC may also experience skin lesions. These can be flat, reddish, and scaly patches; firm, red bumps; wart-like growths that ooze or crust; or a rough patch on the lip (5).

It's essential to note that these symptoms can vary from person to person, and not everyone with pancreatic SCC will experience all of them. If you're experiencing any of these symptoms, it's crucial to consult a healthcare professional for proper diagnosis and treatment.

References:

1. Abedi et al. (2017) - [1]
2. Al-Shehri et al. (2008) - [3]
3. Al-Shehri et al. (2008) - [3]
4. Pancreatic cancer information - [4]
5. Squamous Cell Carinoma Symptoms - [5]

Diagnostic Tests for Pancreatic Squamous Cell Carcinoma

Pancreatic squamous cell carcinoma (PSCC) is a rare and aggressive form of cancer that can be challenging to diagnose. However, various diagnostic tests can help identify this condition.

• Imaging tests: These are often the first line of diagnosis for PSCC. Imaging tests such as:
  • Computed Tomography (CT) scans [7]
  • Magnetic Resonance Imaging (MRI) [7]
  • Endoscopic Ultrasound (EUS) [5, 15]
  • Positron Emission Tomography (PET) scans [9]
  • Cholangiopancreatography [9]

can help identify tumors in the pancreas.

• Blood tests: Blood tests can also be used to diagnose PSCC. These include:

  • CA 19-9 tumor marker test [13, 14], which may indicate the presence of a carcinoma.
  • Liver function tests [10] to check for jaundice and other symptoms associated with pancreatic cancer.

• Biopsy: A biopsy is considered the gold standard for diagnosing PSCC. This involves taking a sample of tissue from the pancreas, which can be examined under a microscope to confirm the presence of squamous cell carcinoma [1, 3].

It's worth noting that due to its rarity, PSCC is often diagnosed after other primary sources have been excluded by appropriate diagnostic tests and histologic techniques [11].

Treatment Options for Pancreatic Squamous Cell Carcinoma (SCC)

Pancreatic SCC is a rare and aggressive form of cancer with limited treatment options. According to recent research, there is no standard therapy established for the management of this disease [4]. However, various therapeutic methods have been used to treat pancreatic SCC, including:

• Surgical resection: Curative resection is considered the best treatment method, but it's only possible in a small percentage of cases. The median survival period after surgery is 7 months [3].
• Chemotherapy: Chemotherapy regimens have been used to treat pancreatic SCC, but these tumors generally do not respond well to chemotherapy or chemoradiotherapy [4].
• Radiation therapy: Radiation therapy has also been used as a treatment option for pancreatic SCC.
• Gemcitabine-based chemoradiotherapy: Anagnostopoulos et al. found that gemcitabine-based chemoradiotherapy was effective in the case of pancreatic SCC [6].

Current Treatment Landscape

According to recent studies, surgical resection is deemed the only conceivably curative treatment for pancreatic SCC [8]. However, adjuvant chemotherapy with gemcitabine or S-1 (an oral fluoropyrimidine) may be considered after surgery. The current treatment landscape for pancreatic SCC is largely based on case reports and small-scale studies.

Future Directions

Further research is needed to develop more effective treatment options for pancreatic SCC. Clinical trials are necessary to evaluate the efficacy of new therapies, such as targeted agents and immunotherapies, in this disease.

References:

[3] G Zhang et al., 2018 - Curative resection is the best treatment method with a median survival period of 7 months. [4] S Kumar Das Majumdar et al., 2019 - There is no standard therapy established for the management of pancreatic SCC (10). [6] B Yang et al., 2021 - Anagnostopoulos et al. found gemcitabine-based chemoradiotherapy was effective in the case of pancreatic SCC (4). [8] AA Mussa, 2020 - Surgical resection is deemed the only conceivably curative treatment (14,17)

The differential diagnosis of pancreatic squamous cell carcinoma (SCC) involves considering various other types of tumors that can present with similar symptoms and characteristics.

According to the available literature, the differential diagnosis of SCC of pancreas should include:

• Solitary papillary tumor (SPT)
• Adenocarcinoma
• Endocrine tumors

These conditions can be difficult to distinguish from SCC based on clinical presentation alone, and a definitive diagnosis often requires histopathological examination.

In addition, adenosquamous carcinoma is also considered in the differential diagnosis of SCC. This rare variant of pancreatic cancer shows characteristics of both ductal adenocarcinoma and squamous cell carcinoma, making it challenging to diagnose accurately.

It's worth noting that primary squamous cell carcinoma of pancreas is a rare malignant neoplasm with limited clinical information available due to its rarity.

Sources:

• [1] Kim JB. The differential diagnosis of SCC of pancreas should be considered such as solitary papillary tumor (SPT), adenocarcinoma, and endocrine tumors.
• [2] Olson MT. The differential diagnosis of squamous cells in pancreatic aspirates: From contamination to adenosquamous carcinoma.
• [3] Marak JR. Primary squamous cell carcinoma of pancreas is a rare malignant neoplasm.
• [4] Kodavatiganti R. Adenosquamous carcinoma and pancreatoblastoma were considered in the differential diagnosis.
• [5] Zhang G. Primary squamous cell carcinoma of the pancreas with ... Adenosquamous carcinoma should be usually considered in the differential diagnosis of SCC.