Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report

Abstract Background Liver metastasis of pure squamous cell carcinoma (SCC) from pancreatic ductal adenocarcinoma has not been previously reported. Case presentation A 66-year-old man underwent a computed tomography scan 3 years after surgery for pancreatic head cancer, and the scan revealed a mass l...

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Main Authors: Yohei Mano, Keishi Sugimachi, Tomonari Shimagaki, Takahiro Tomino, Emi Onishi, Lingaku Lee, Terumasa Hisano, Yutaka Koga, Kenichi Taguchi, Masaru Morita, Yasushi Toh
Format: Article
Language:English
Published: Japan Surgical Society 2023-09-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-023-01755-z
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author Yohei Mano
Keishi Sugimachi
Tomonari Shimagaki
Takahiro Tomino
Emi Onishi
Lingaku Lee
Terumasa Hisano
Yutaka Koga
Kenichi Taguchi
Masaru Morita
Yasushi Toh
author_facet Yohei Mano
Keishi Sugimachi
Tomonari Shimagaki
Takahiro Tomino
Emi Onishi
Lingaku Lee
Terumasa Hisano
Yutaka Koga
Kenichi Taguchi
Masaru Morita
Yasushi Toh
author_sort Yohei Mano
collection DOAJ
description Abstract Background Liver metastasis of pure squamous cell carcinoma (SCC) from pancreatic ductal adenocarcinoma has not been previously reported. Case presentation A 66-year-old man underwent a computed tomography scan 3 years after surgery for pancreatic head cancer, and the scan revealed a mass lesion in the right lobe of the liver. A liver tumor biopsy was performed, and SCC was diagnosed. Whole sections of the pancreatic head cancer were re-evaluated, but no areas of SCC-like differentiation were identified. Although the pathology differed between the pancreas and liver, metastasis of adenosquamous carcinoma was considered. Three courses of gemcitabine plus nab-paclitaxel were administered to treat the liver metastasis of pancreatic cancer, but no response was attained. Therefore, primary SCC of the liver was considered and hepatic resection was performed. The tumor had invaded the diaphragm, and S5/6 partial hepatic resection with right diaphragm resection was performed. Pathological examination showed pure SCC of the liver, which differed from the pancreatic cancer. KRAS mutations were evaluated in the pancreatic and liver tumor specimens, and Q61R mutation was identified in both specimens. This pure SCC of the liver was diagnosed as metastasis from pancreatic cancer not by histology but by genetic analysis. Conclusions This is the first reported case of pure SCC liver metastasis from pancreatic cancer without a squamous cell component in the primary tumor. Evaluation of KRAS mutations in both specimens was useful for diagnosis.
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spelling doaj-art-5141521564f4447f9d9bc669eecded2f2025-08-20T03:34:35ZengJapan Surgical SocietySurgical Case Reports2198-77932023-09-01911510.1186/s40792-023-01755-zLiver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case reportYohei Mano0Keishi Sugimachi1Tomonari Shimagaki2Takahiro Tomino3Emi Onishi4Lingaku Lee5Terumasa Hisano6Yutaka Koga7Kenichi Taguchi8Masaru Morita9Yasushi Toh10Department of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer CenterDepartment of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer CenterDepartment of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer CenterDepartment of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer CenterDepartment of Hepato-Biliary and Pancreatic Surgery, National Hospital Organization Kyushu Cancer CenterDepartment of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer CenterDepartment of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer CenterDepartment of Pathology, National Hospital Organization Kyushu Cancer CenterDepartment of Pathology, National Hospital Organization Kyushu Cancer CenterDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer CenterDepartment of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer CenterAbstract Background Liver metastasis of pure squamous cell carcinoma (SCC) from pancreatic ductal adenocarcinoma has not been previously reported. Case presentation A 66-year-old man underwent a computed tomography scan 3 years after surgery for pancreatic head cancer, and the scan revealed a mass lesion in the right lobe of the liver. A liver tumor biopsy was performed, and SCC was diagnosed. Whole sections of the pancreatic head cancer were re-evaluated, but no areas of SCC-like differentiation were identified. Although the pathology differed between the pancreas and liver, metastasis of adenosquamous carcinoma was considered. Three courses of gemcitabine plus nab-paclitaxel were administered to treat the liver metastasis of pancreatic cancer, but no response was attained. Therefore, primary SCC of the liver was considered and hepatic resection was performed. The tumor had invaded the diaphragm, and S5/6 partial hepatic resection with right diaphragm resection was performed. Pathological examination showed pure SCC of the liver, which differed from the pancreatic cancer. KRAS mutations were evaluated in the pancreatic and liver tumor specimens, and Q61R mutation was identified in both specimens. This pure SCC of the liver was diagnosed as metastasis from pancreatic cancer not by histology but by genetic analysis. Conclusions This is the first reported case of pure SCC liver metastasis from pancreatic cancer without a squamous cell component in the primary tumor. Evaluation of KRAS mutations in both specimens was useful for diagnosis.https://doi.org/10.1186/s40792-023-01755-zPancreatic cancerSquamous cell carcinomaLiver metastasisKRAS mutation
spellingShingle Yohei Mano
Keishi Sugimachi
Tomonari Shimagaki
Takahiro Tomino
Emi Onishi
Lingaku Lee
Terumasa Hisano
Yutaka Koga
Kenichi Taguchi
Masaru Morita
Yasushi Toh
Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
Surgical Case Reports
Pancreatic cancer
Squamous cell carcinoma
Liver metastasis
KRAS mutation
title Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
title_full Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
title_fullStr Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
title_full_unstemmed Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
title_short Liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma: a case report
title_sort liver metastasis composed of pure squamous cell carcinoma component from pancreatic pure ductal adenocarcinoma a case report
topic Pancreatic cancer
Squamous cell carcinoma
Liver metastasis
KRAS mutation
url https://doi.org/10.1186/s40792-023-01755-z
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