Squamous/Adenosquamous Carcinoma, Pancreas

 Glandular component may contain conventional ductal-type, clear cell, or signet ring cell components






Ancillary Tests




• p63 is positive in squamous component

• Mucin stain, CK7, CK20, CEA, and CA19-9 highlight adenocarcinoma component


Top Differential Diagnoses




• Metastatic squamous cell carcinoma

• Pancreatoblastoma

image
Solid-Cystic Mass
Primary adenosquamous cell carcinoma in the tail of the pancreas shows a relatively well-demarcated, tan-white to yellow solid mass image with a cystic component image .


image
Squamous and Glandular Areas
Adenosquamous cell carcinoma of the pancreas demonstrates islands of malignant squamous cells with keratinization image adjacent to high-grade pancreatic intraepithelial neoplasia involving an interlobular duct image .

image
p63 Stain
Immunohistochemical stain for p63 shows nuclear staining in the squamous component image of adenosquamous cell carcinoma, while the glandular component is negative image .

image
CEA Stain
Immunohistochemical stain for carcinoembryonic antigen highlights the glandular component image, while the squamous component image is negative.


TERMINOLOGY


Synonyms




• Adenoacanthoma

• Mixed squamous/adenocarcinoma

• Mucoepidermoid carcinoma


Definitions




• Uncommon variant of pancreatic cancer with both glandular and squamous differentiation
image Pure squamous cell carcinoma of pancreas is vanishingly rare


ETIOLOGY/PATHOGENESIS


Neoplastic




• A few hypotheses attempt to explain origin of squamous component
image Squamous metaplasia of pancreatic duct epithelium

image Both components derive from common progenitor

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Apr 20, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Squamous/Adenosquamous Carcinoma, Pancreas

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