Adenosquamous carcinoma of the pancreas

Abstract

Background/aims: Adenosquamous carcinoma (ASC) of the pancreas is rare and correct preoperative diagnosis is difficult. Case reports of ASC of the pancreas are sporadic and have typically employed small series. This study investigated the clinicopathological features of 7 cases of ASC of the pancreas and reviewed the pertinent literature to elucidate this rare disease.

Methodology: Seven patients (4 men and 3 women; age range 38-79 years; median 66 years) with ASC of the pancreas who underwent surgical treatment at Chang Gung Memorial Hospital between February 1993 and April 2000 were retrospectively reviewed.

Results: Symptoms of ASC were as follows: abdominal pain (85.7%), body weight loss (85.7%), jaundice (42.9%) and anorexia (42.9%). The tumors were located at the head of the pancreas in 4 patients (57.1%), at the body in 2, and at the tail in 2. One patient had ASC at the body and tail. Most cases (5/7, 71.4%) were anemic. Seven (100%) and 5 patients (71.4%) had elevated serum CEA and CA19-9 levels, respectively. Curative pancreaticoduodenectomy was performed on 2 patients, bypass surgery on 3, and exploratory laparotomy on 2. Two patients underwent intraoperative radiotherapy. Three patients received postoperative adjuvant chemotherapy. No surgical mortality or morbidity occurred. Five of 7 patients (71.4%) died within 6 months after surgery. The median survival of the 7 patients was 4.41 months (range 1.12-22.42).

Conclusions: Patients with ASC present symptoms similar to those of adenocarcinoma of the pancreas. Most patients had dismal prognosis despite aggressive surgery with or without adjuvant therapy.