Primary squamous cell carcinoma arising in the liver: A case report and review of literature

Background

Primary hepatic squamous cell carcinoma (PHSCC) is extremely rare, accounting for approximately 0.2% of all primary liver malignancies. PHSCC lacks specific clinical manifestations and is usually diagnosed at an advanced stage. Currently, no disease-specific diagnostic or therapeutic guidelines are available. Management of PHSCC generally follows protocols for hepatocellular carcinoma. The prognosis of PHSCC remains poor, with a reported median overall survival of less than 1 year. CASE SUMMARY We report the case of a 62-year-old Han Chinese man admitted with a 7-day history of persistent right upper abdominal distension and pain, accompanied by fatigue and loss of appetite. Physical examination revealed right upper abdominal tenderness. Contrast-enhanced abdominal computed tomography demonstrated a large hypodense mass involving the left hepatic lobe and the right anterior hepatic lobe. Ultrasound-guided liver biopsy and subsequent histopathological examination confirmed PHSCC after extrahepatic primary sites were excluded. Following multidisciplinary team (MDT) evaluation, the patient received transarterial interventional therapy combined with an immune checkpoint inhibitor (ICI). Post-treatment imaging demonstrated marked tumor regression. The patient achieved an overall survival of 28 months. We also reviewed the relevant literature to summarize the diagnostic challenges and therapeutic approaches for this rare malignancy.

Conclusion

This case suggests that, for selected patients with unresectable PHSCC, an MDT-guided strategy incorporating transarterial interventional therapy and an ICI may represent a potential individualized therapeutic option.