Gao Lei, Tang Xiaolong, Qu Hui, He Qingsi, Sun Guorui, Shi Jingbo, Ye Jianhong, Liang Yahang
Qilu Medical College of Shandong University.
Department of General Surgery, Qilu Hospital of Shandong University, Jinan China.
Medicine (Baltimore). 2020 Sep 4;99(36):e22125. doi: 10.1097/MD.0000000000022125.
Primary gastric squamous cell carcinoma (SCC) is rarely encountered clinically. SCC, which presents as a submucosal tumor, is even rarer. Without the support of pathological evidence, it is difficult to make a correct preoperative diagnosis. Due to limited clinical data, the pathogenesis and treatment of gastric SCC remain unclear.
A 69-year-old man was admitted to our hospital with unexplained weight loss. Endoscopy revealed a submucosal mass without any ulcer on its surface located on the body of the stomach. The results of 2 gastroscopic mucosal biopsies were chronic inflammation.
The clinical diagnosis by computed tomography (CT) and gastroscopy was gastrointestinal stromal tumor (GIST) preoperatively. The postoperative pathological examination demonstrated this tumor as moderately differentiated SCC.
Total gastrectomy, distal pancreatectomy, and splenectomy were performed.
The patient was discharged 7 days after the surgery without any complications. The follow-up CT scan showed no evidence of metastatic disease 6 months after surgery.
Large primary gastric SCC could present as a submucosal mass. Gastroscopic mucosal biopsy may not be able to get tumor tissue due to inflammatory reaction.
原发性胃鳞状细胞癌（SCC）在临床上很少见。表现为黏膜下肿瘤的SCC则更为罕见。没有病理证据的支持，很难做出正确的术前诊断。由于临床数据有限，胃SCC的发病机制和治疗方法仍不清楚。
一名69岁男性因不明原因体重减轻入院。内镜检查发现胃体部有一个黏膜下肿块，表面无溃疡。两次胃镜黏膜活检结果均为慢性炎症。
术前计算机断层扫描（CT）和胃镜检查的临床诊断为胃肠道间质瘤（GIST）。术后病理检查显示该肿瘤为中分化SCC。
实施了全胃切除术、远端胰腺切除术和脾切除术。
患者术后7天出院，无任何并发症。术后6个月的随访CT扫描显示无转移疾病迹象。
原发性大胃SCC可能表现为黏膜下肿块。由于炎症反应，胃镜黏膜活检可能无法获取肿瘤组织。
