DOI: 10.12890/2025_005901

Primary gastric squamous cell carcinoma: challenges in treatment strategy

Authors

  • Manh Thang Hoang Hanoi Medical University, Hanoi, Vietnam; Vietnam National Cancer Hospital, Hanoi, Vietnam 0009-0006-6280-8146
  • Anh Hoang Hanoi Medical University, Hanoi, Vietnam; Vietnam National Cancer Hospital, Hanoi, Vietnam 0009-0001-2753-872X
  • Van Vụ Kim Hanoi Medical University, Hanoi, Vietnam; Vietnam National Cancer Hospital, Hanoi, Vietnam
  • Trung Thong Pham Vietnam National Cancer Hospital, Hanoi, Vietnam
  • Van Trong Nguyen Vietnam National Cancer Hospital, Hanoi, Vietnam 0000-0001-7920-2358
  • Mau Thai Nguyen Vietnam National Cancer Hospital, Hanoi, Vietnam

drhoanganh@hmu.edu.vn

Keywords

Gastric squamous cell carcinoma (GSCC), rare gastric malignancy, radical surgery, adjuvant chemotherapy

Abstract

Background: Primary gastric squamous cell carcinoma (GSCC) is an extremely rare malignancy, accounting for approximately 0.04–0.07% of all gastric malignant tumours. The disease carries a poor prognosis, and there is currently no globally standardised treatment protocol.
Case description: A 59-year-old female patient with no significant medical history presented with prolonged epigastric pain. Gastroscopy revealed a 5 × 7 cm ulcerated mass along the greater curvature of the gastric body; biopsy confirmed squamous cell carcinoma. Computed tomography (CT) demonstrated tumour invasion through the serosa with perigastric fat infiltration and multiple perigastric lymph nodes >1 cm (the largest node in station 10 measuring 5 cm); tumour marker CA72-4 was elevated at 29.3 U/ml. Comprehensive evaluation revealed no primary lesions at other sites, including esophagogastroduodenoscopy, colonoscopy, chest CT and physical examination. Primary squamous cell carcinoma of the gastric body, cT4N2M0. The patient underwent total gastrectomy, distal pancreatectomy, splenectomy and D2+ lymphadenectomy (including stations 12b, 12p, 13). Histopathological examination confirmed poorly differentiated squamous cell carcinoma with serosal invasion, invasion into the greater omentum, lymphovascular invasion (LVI+) and perineural invasion (PNI+), with 7/25 lymph nodes positive for metastasis. Immunohistochemistry showed diffuse positivity for p63, CK5/6 and CK7; p16 was negative. Post-operative staging: pT4bN3aM0, LVI+, PNI+. The patient received adjuvant chemotherapy with eight cycles of the XELOX regimen.
Conclusion: GSCC is a rare disease entity with a poor prognosis. Radical resection combined with adjuvant chemotherapy represents a reasonable approach for resectable disease. Multicentre studies and clinical trials are needed to establish optimal treatment protocols for this rare malignancy.

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References

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Published

2025-11-05

Issue

Vol. 12 No. 12 (2025)

Categories

How to Cite

1.
Hoang MT, Hoang A, Kim VV, Pham TT, Nguyen VT, Nguyen MT. Primary gastric squamous cell carcinoma: challenges in treatment strategy. EJCRIM [Internet]. 2025 Nov. 5 [cited 2026 Nov. 3];12(12). Available from: https://ejcrim.com/index.php/ejcrim/article/view/5901