2019 Volume 34 Issue 5 Pages 222-231
Adenosquamous carcinoma (ASC) of the pancreas is believed to be associated with a poor prognosis. We report a patient with ASC who has survived for 17 years after resection without adjuvant chemotherapy. A 60-year-old man presented with left lower abdominal pain. Laboratory data showed an elevation of carbohydrate antigen 19-9 (232U/ml), and s-pancreas-1 antigen (96U/ml) without elevation of squamous cell carcinoma-related antigen. Ultrasound revealed a 4×3×3cm ellipsoid solid tumor with central cystic degeneration in the pancreatic tail. Dynamic CT scan showed a mildly enhanced solid portion of the tumor in the portal and delayed phases. MRI/MRCP showed a 2cm cystic element with a mural nodule and a dilated distal main pancreatic duct. Distal pancreatectomy (body-tail) with regional lymph node dissection was performed. Pathology showed ASC of the pancreas (T2N0M0, Stage IB). The tumor was covered with a thick pseudo-capsule and composed mostly of squamous cell carcinoma, accompanied by a cavity derived from central necrosis. Inside and adjacent to the tumor was an adenocarcinoma component, mostly in the form of carcinoma-in-situ. He has been well without recurrence for 17 years since surgery.
