A case of primary squamous cell carcinoma of the stomach

Abstract

We report a case of a patient with primary squamous cell carcinoma of the stomach with elevated levels of serum granulocyte-colony stimulating factor (G-CSF). A 66-year-old man was admitted to our hospital with general fatigue, and endoscopic examination revealed type 1 gastric cancer in the posterior wall of the proximal third of his stomach. The preoperative laboratory data indicated a high level of serum squamous cell carcinoma antigen (130 ng/ml). FDG-PET revealed a 1.5 cm metastasis in S7 of the liver. Total gastrectomy, resection of the pancreatic body and tail, splenectomy, partial resection of the liver (S7), and cholecystectomy were performed with a preoperative diagnosis of G-CSF-producing gastric cancer. Pathological examination confirmed that it was squamous cell carcinoma, pT4a (SE), pNO (0/27), pHl, pStage IV. The patient is alive 26 months after the operation without recurrent disease. Poorly differentiated adenocarcinoma is the most frequent form of G-CSF-producing gastric cancer, and adenosquamous cell carcinoma is the second. In terms of the histological type, although G-CSF-producing tumors are often seen in cases of squamous cell carcinoma, the present case is apparently the first report of primary squamous cell carcinoma of the stomach. © 2012 The Japanese Society of Gastroenterological Surgery.