Clinical Diagnosis And Treatment Of Pancreatic Adenosquamous Carcinoma: An Analysis Of 10 Cases

Objective: Pancreatic adenosquamous carcinoma(PASC)is a rare subtype of pancreatic malignant tumor.This article summarizes the diagnosis,treatment experience,postoperative clinicopathological features and prognosis of pancreatic adenosquamous carcinoma,and improves the understanding and diagnosis of the disease.Methods: The clinical data characteristics of 10 patients with pancreatic adenosquamous carcinoma treated in the First Affiliated Hospital of China Medical University from January 2012 to October 2018 were retrospectively analyzed and discussed in the literature.Results: There were 10 patients with pancreatic adenosquamous carcinoma in this group,including 6 males and 4 females,with an average age of 61.4 years.The symptoms included abdominal pain 8 cases,weight loss 7 cases,loss of appetite 5 cases,and jaundice 3 cases.The tumors were located in the head of the pancreas in 4 cases and the tail of the pancreas in 6 cases.The average size of the tumor was 5.2 cm.All 10 patients underwent surgical treatment,including pancreaticoduodenectomy in 4 cases;pancreatic body and tail resection in 6 cases,including 2 cases of tumor invasion of the colon and splenic flexure with partial colectomy,and 1 case of invasion of the left adrenal gland and part of the stomach.The posterior wall and colonic spleen curvature were removed by pancreatic body and tail resection,left adrenal resection,partial posterior gastric wall resection,and colonic splenic resection.Pathologically confirmed pancreatic adenosquamous carcinoma after surgery.Microscopically,adenocarcinoma and squamous carcinoma cells were composed together.Three cases of tumors involved nerve invasion.During follow-up,2 cases were lost to follow-up.Among the 8 cases who were followed up,1 died of abdominal complications due to surgical complications 1.5months after surgery,4 patients did not receive follow-up treatment such as radiotherapy and chemotherapy after discharge,2 of them died of liver metastasis,One patient died of cirrhosis,and the survival time was 1.5 to 13 months,with an average of 6.4 months.Of the 4 surviving patients,3 received postoperative chemotherapy,with a survival time of17.4 to 34.5 months,with an average of 24.3 months.Conclusion: Pancreatic adenosquamous carcinoma is a rare pancreatic exocrinemalignant tumor.The histological feature is a mixture of adenocarcinoma and squamous carcinoma,which show aggressive growth and easily invade surrounding organs,blood vessels,liver,colon,and lymph node metastases.High prognosis is poor,and aggressive surgical treatment combined with chemotherapy antitumor therapy can improve the therapeutic effect.