SHM Converge Scientific Abstract ePoster Gallery-Primary Squamous Cell Carcinoma of the Stomach: A Rare Find

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This poster describes a rare case of primary squamous cell carcinoma of the stomach (GSCC), which accounts for only about 0.2% of gastric cancers and is known to be aggressive, poorly understood, and lacking established treatment guidelines.<br /><br />A 61-year-old man with hypertension, hyperlipidemia, and alcohol use presented with epigastric discomfort, melena, fatigue, dizziness, and anemia. CT imaging showed a mass in the proximal stomach near the gastroesophageal junction with suspicious lymphadenopathy. Endoscopy confirmed an ulcerated bleeding gastric cardia mass. Biopsy of a perigastric lymph node later confirmed metastatic squamous cell carcinoma.<br /><br />Because the disease was initially thought to be advanced and unresectable, the patient was treated with neoadjuvant radiation and weekly carboplatin/paclitaxel. However, he had a serious cardiac event during paclitaxel therapy and was switched to a different regimen with continued radiation. PET imaging showed persistent gastric disease and new thoracic adenopathy. Due to poor response, ongoing anemia, and progression, he ultimately underwent extensive surgery including gastrectomy with Roux-en-Y esophagojejunostomy, partial liver resection, and omentectomy.<br /><br />Pathology confirmed a 4.5 cm moderately differentiated squamous cell carcinoma with invasion into adjacent organs, lymphatic and perineural invasion, and positive regional lymph nodes, consistent with advanced disease. Later imaging and endoscopy showed further metastatic spread, including a new esophageal lesion.<br /><br />Molecular testing revealed ERBB2 amplification, PD-L1 positivity (CPS 10), and other alterations, suggesting potential benefit from immunotherapy. The authors emphasize that GSCC may share biomarker patterns with gastric adenocarcinoma and could potentially respond to checkpoint inhibitors such as nivolumab. They conclude that more research is needed to define the role of radiotherapy, surgery, chemotherapy, and immunotherapy in this rare cancer.

Asset Subtitle

Heyue Du

Meta Tag

Author List Adnan Younus, Heyue Du, Huzaifa Khalid, Milcah Larks MD, Mubasshar Shahid, Muhammad Jibran, Qamar Iqbal

Category Clinical Vignettes

Concept Primary Squamous Cell Carcinoma of the Stomach

Concept Diagnostic Workup

Concept Biopsy

Concept Gastric Malignancy

Concept Endoscopy

Distinguished Non-Finalist

Presenter Organization TidalHealth

Presenting Author Heyue Du

Track Adult

Keywords

gastric squamous cell carcinoma

primary gastric cancer

rare malignancy

gastroesophageal junction

metastatic lymphadenopathy

neoadjuvant chemoradiation

gastrectomy

ERBB2 amplification

PD-L1 positivity

immunotherapy

Primary Squamous Cell Carcinoma of the Stomach

Diagnostic Workup

Biopsy

Gastric Malignancy

Endoscopy