Squamous cell carcinoma as a rare entity of primary liver tumor with grave prognosis

The development of primary squamous cell carcinoma (SCC) of the liver has only rarely been reported in association with pre-existing hepatic cysts and biliary tract diseases. This report describes an unusual case of SCC originating in a cirrhotic liver. A 63-year-old male alcoholic was incidentally found to have a 6-cm liver tumor which showed mixed echogenic by sonography and a low-density area with rim enhancement by computed tomography. Tumor biopsy led to a diagnosis of SCC with a sarcomatoid change. The tumor showed fatal rapid growth accompanied by abdominal pain. Transcatheter arterial embolization and chemotherapy were not effective, and the tumor increased to 13cm in diameter over an 8-month period. A post-mortem search revealed no alternative primary tumor site other than liver. Review of the literature shows that abdominal pain is a chief symptom of primary liver SCC. Only three of the nine patients treated with hepatic resection survived without recurrence during 8 months to 4 years of follow-up. We propose that SCC with a grave prognosis should be considered as a rare entity of primary liver tumor even in cirrhotic patients.