Preeti Nallan Chakravarthula,, MD, Ifeoma p. Kwentoh, MD, Gerald Fletcher, MBA, MD, Meena Ahluwalia, MD Harlem Hospital Center/NYCHHC/HHC, New York, NY
Introduction: Epidermoid carcinoma, mostly occur in the skin or mucous membranes of the digestive and respiratory systems. Primary squamous cell carcinoma in the pancreas is extremely rare, accounting for about 0.05%–2% of pancreatic malignant tumors.
Case Description/Methods: 61-year-old woman with past medical history of poorly controlled HIV/AIDS (CD4 21 in 1/2023, VL 34800 in 7/2022), alcohol use disorder, chronic active smoker presented on 1/25/23 with complaint of epigastric pain, 10/10 intensity radiating to the sides for 2 weeks associated with non-bloody diarrhea of 3 days duration. Patient was initially admitted for concern for pancreatitis however lipase on admission was normal. On physical exam she was anicteric with CT abdomen showing edematous pancreas without signs of acute or chronic pancreatitis as evidenced by normal sized pancreas with no calcifications, fat stranding or ductal dilatation. However, there was concern for a heterogenous mass in the mid-posterior portion. MRI Abdomen and MRCP confirmed a 5.5 x 2.7 x 5.0 cm mixed cystic solid mass within mid body of pancreas with no ductal dilatation or stone. Peripancreatic LN 1.1 cm was the only pathologically enlarged LN. CEA and CA 19-9 were within normal limits. EUS+FNA was performed which revealed LA grade D esophagitis and a 41 x 36mm mass in the peritoneal cavity posterior to the stomach. FNA revealed carcinoma with squamous differentiation with tumor cells positive for p40 and p63. However due to limited sample unclear if adenosquamous vs pure squamous. Imaging for staging revealed tumor encasing of celiac and common hepatic artery, possible left diaphragmatic involvement, however no suggestion of widespread metastasis or extensive LN involvement. Our assessment at this point is locally invasive disease which will require 4-6 weeks of chemoradiotherapy at least. Patient’s care was coordinated with a higher center for the same.
Discussion: we report a rare case of primary squamous cell carcinoma of the pancreas in HIV/AIDS in the setting of HIV/AIDS. Primary squamous cell carcinoma (SCC) of the pancreas, is diagnosed by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). This is one of the first reported AIDS associated primary squamous cell carcinoma of pancreas.
Figure: Figure 1: ENDOSONOGRAPHIC FINDING: - A round mass was identified endosonographically in the perigastric peritoneal space within the BOP region. The mass was heterogenous. The mass measured 41 mm by 36 mm in maximal cross-sectional diameter. The endosonographic
Disclosures:
Preeti Nallan Chakravarthula, indicated no relevant financial relationships.
Ifeoma Kwentoh indicated no relevant financial relationships.
Gerald Fletcher indicated no relevant financial relationships.
Meena Ahluwalia indicated no relevant financial relationships.
Preeti Nallan Chakravarthula,, MD, Ifeoma p. Kwentoh, MD, Gerald Fletcher, MBA, MD, Meena Ahluwalia, MD. P2958 - Primary Squamous Cell Carcinoma of the Pancreas in HIV/AIDS: An Overlooked AIDS Defining Criteria, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
