Primary squamous cell carcinoma of the stomach. Report of a case and review of literature.

Primary squamous cell carcinomas of the stomach represent a rare entity. Since the first report in 1895 by Rörig et al. (1) only 80 cases have been published. These reports show a peak incidence in the sixth decade of life and preference of male gender (5:1). We report the case of a 61-year-old patient who presented with anemia and weight loss due to a large tumor of the gastric wall with adhesion to the pancreatic tail. After radical regional "en bloc" gastrectomy, splenectomy and pancreatic tail resection, the diagnosis of primary gastric squamous cell carcinoma could be confirmed, since the esophageal wall and the pancreatic tail were not infiltrated and extragastric squamous cell primaries could be excluded. After postoperative irradiation of the upper abdominal area, the patient developed a single liver metastasis in the left hepatic lobe that decreased with polychemotherapy. It was resected half a year later. Due mainly to advanced tumor stages, survival after surgical resection is poor. However, adjuvant radio and chemotherapy have resulted in survival rates of more than 3 years in reported cases, as in the present case. Five years after the diagnosis was established the patient is free of recurrence and without any complaint. Pathophysiological features, therapy and outcome are discussed by reviewing the cases reported in world literature.