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Peer-reviewedCC BY 4.0Frontiers in Medicine

Case Report: Primary squamous cell carcinoma of the pancreas in a 75-year-old woman with a marked response to chemoimmunotherapy and conversion surgery

  • Xiaokun Hu1
  • Yue Shi2
  • Qiuyu Yu1
  • Qingqing Zhu1
  1. 1Department of Radiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
  2. 2Department of Pathology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Abstract

Primary squamous cell carcinoma (SCC) of the pancreas is an extremely rare malignancy. Herein, we report a case of poorly differentiated primary pancreatic SCC in a 75-year-old woman. Computed tomography revealed a solid mass with cystic degeneration in the pancreatic head and neck with extensive central necrosis, abutment of the celiac axis and encasement of the main portal vein, while diffusion-weighted magnetic resonance imaging demonstrated restricted diffusion in the solid component. After multidisciplinary consensus, the patient received off-label nab-paclitaxel and gemcitabine combined with the PD-1 inhibitor serplulimab. After three cycles, serum CA19-9 decreased from 40.4 U/mL at baseline to 16.04 U/mL (reference range, < 37 U/mL) and the tumor regressed markedly on imaging. Subsequently, pancreaticoduodenectomy with segmental portal vein resection and reconstruction was successfully performed, achieving R0 resection without lymph node metastasis. Histopathology confirmed poorly differentiated SCC. No recurrence or metastasis was detected during five months of postoperative follow-up. In this report, we aim to provide imaging details that may facilitate recognition of this rare pancreatic malignancy and suggest that PD-1-based chemoimmunotherapy merits prospective evaluation as a conversion strategy in locally advanced disease.

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Cite

BibTeXRIS
BibTeX
@article{hu2026case,
  title = {{Case Report: Primary squamous cell carcinoma of the pancreas in a 75-year-old woman with a marked response to chemoimmunotherapy and conversion surgery}},
  author = {Xiaokun Hu and Yue Shi and Qiuyu Yu and Qingqing Zhu},
  journal = {Frontiers in Medicine},
  year = {2026},
  month = oct,
  doi = {10.3389/fmed.2026.1990719},
  url = {https://doi.org/10.3389/fmed.2026.1990719},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Case Report: Primary squamous cell carcinoma of the pancreas in a 75-year-old woman with a marked response to chemoimmunotherapy and conversion surgery
AU  - Xiaokun Hu
AU  - Yue Shi
AU  - Qiuyu Yu
AU  - Qingqing Zhu
PY  - 2026
DA  - 2026/10/21
JO  - Frontiers in Medicine
DO  - 10.3389/fmed.2026.1990719
UR  - https://doi.org/10.3389/fmed.2026.1990719
AB  - Primary squamous cell carcinoma (SCC) of the pancreas is an extremely rare malignancy. Herein, we report a case of poorly differentiated primary pancreatic SCC in a 75-year-old woman. Computed tomography revealed a solid mass with cystic degeneration in the pancreatic head and neck with extensive central necrosis, abutment of the celiac axis and encasement of the main portal vein, while diffusion-weighted magnetic resonance imaging demonstrated restricted diffusion in the solid component. After multidisciplinary consensus, the patient received off-label nab-paclitaxel and gemcitabine combined with the PD-1 inhibitor serplulimab. After three cycles, serum CA19-9 decreased from 40.4 U/mL at baseline to 16.04 U/mL (reference range, < 37 U/mL) and the tumor regressed markedly on imaging. Subsequently, pancreaticoduodenectomy with segmental portal vein resection and reconstruction was successfully performed, achieving R0 resection without lymph node metastasis. Histopathology confirmed poorly differentiated SCC. No recurrence or metastasis was detected during five months of postoperative follow-up. In this report, we aim to provide imaging details that may facilitate recognition of this rare pancreatic malignancy and suggest that PD-1-based chemoimmunotherapy merits prospective evaluation as a conversion strategy in locally advanced disease.
SN  - 2296-858X
ER  -