Terada Tadashi
Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan.
Case Rep Gastroenterol. 2010 Sep 18;4(3):369-373. doi: 10.1159/000320675.
Adenosquamous carcinoma (ASC) and pure squamous cell carcinoma (SCC) of the pancreas are very rare diseases. The author herein reports two cases of ASC and SCC of the pancreas. The first case is ASC. An 80-year-old woman was admitted to our hospital because of abdominal pain and weakness. Imaging modalities including CT, MRI and ERCP revealed a pancreatic body tumor. Distal partial resection of the pancreas and splenectomy were performed. Grossly, an infiltrative solid tumor measuring 3 × 4 × 4 cm was present in the pancreatic body. Histologically, it was an ASC consisting of poorly differentiated adenocarcinoma element (20% in area) and SCC element (80%). There was a gradual transition between the two. Many perineural invasions and lymphovascular permeations were recognized. The patient died of systemic metastasis five months after operation. The second case is an SCC. A 69-year-old woman presented with abdominal pain and jaundice. Imaging modalities including CT, MRI and ERCP revealed a tumor in the head of the pancreas. Pancreaticoduodenectomy was performed. Grossly, an infiltrative solid tumor measuring 5 × 5 × 6 cm was present. Histologically, the tumor was pure SCC. The SCC was moderately differentiated SCC. A large number of perineural invasions and lymphovascular permeations were present. The patient died of systemic metastasis three months after operation. The author speculates that ASC of the pancreas may be derived from squamous tansdifferentiation of adenocarcinoma element or from pluripotent stem cells, and that SCC of the pancreas may arise from malignant transformation of squamous metaplasia of pancreatic ducts or from pluripotent stem cells.
胰腺腺鳞癌（ASC）和纯鳞状细胞癌（SCC）是非常罕见的疾病。本文作者报告了两例胰腺ASC和SCC病例。第一例是ASC。一名80岁女性因腹痛和身体虚弱入住我院。包括CT、MRI和ERCP在内的影像学检查显示胰体有肿瘤。行胰腺远端部分切除术和脾切除术。大体上，胰体有一个浸润性实性肿瘤，大小为3×4×4cm。组织学上，它是一种ASC，由低分化腺癌成分（面积占20%）和SCC成分（占80%）组成。两者之间有逐渐过渡。可见许多神经周围侵犯和淋巴管浸润。患者术后五个月死于全身转移。第二例是SCC。一名69岁女性出现腹痛和黄疸。包括CT、MRI和ERCP在内的影像学检查显示胰头有肿瘤。行胰十二指肠切除术。大体上，有一个浸润性实性肿瘤，大小为5×5×6cm。组织学上，肿瘤为纯SCC。该SCC为中度分化SCC。存在大量神经周围侵犯和淋巴管浸润。患者术后三个月死于全身转移。作者推测胰腺ASC可能源于腺癌成分的鳞状化生或多能干细胞，而胰腺SCC可能源于胰管鳞状化生的恶性转化或多能干细胞。
