Gastric squamous cell carcinoma: Is neoadjuvant chemotherapy always effective? A case report

Gastric squamous cell carcinoma (GSCC) is a rare condition. We present the case of a locally advanced GSCC with dissociated response after neoadjuvant chemotherapy.

We present the case of a 34-year-old female patient who presented with a two-month history of epigastric pain and vomiting. Esophagogastroduodenoscopy identified a fundic lesion. Biopsy revealed a GSCC. CT scan showed a locally advanced expansile nodular process on the greater curvature of the stomach. Due to the locally advanced nature of the tumor, surgery was deemed excessively mutilating, and chemotherapy was initiated. The endoscopic evaluation showed complete resolution of the fundic mass. CT imaging demonstrated a 37 % reduction in the volume of target lesions. The patient subsequently underwent diagnostic laparoscopy, revealing a locally advanced unresectable tumor accompanied by diffuse peritoneal carcinomatosis. Palliative chemotherapy was initiated. The patient passed away two months after surgery.

GSCC is a rare condition. The exact origin of this tumor remains unclear. Clinically, GSCC presents similarly to other gastric tumors. Due to its rarity, there is no consensus on the optimal treatment for primary gastric squamous cell carcinoma, and the existing evidence is primarily based on case reports and small case series. Radical surgical excision with lymph node dissection remains the primary therapeutic approach. While neoadjuvant chemotherapy appears beneficial and effective, the available data remain limited. GSCC is known for its locally aggressive behavior and poor short-term prognosis.

Additional research is crucial to establish the most effective treatment strategies.