# Primary Hepatic Squamous Cell Carcinoma

## TL;DR

This case study describes a rare liver cancer called primary hepatic squamous cell carcinoma in an elderly man with unusual imaging and tissue features.

## Contribution

The study presents a unique case of primary hepatic SCC with distinct histopathological and immunohistochemical features.

## Key findings

- The tumor showed hypervascular nodules on contrast-enhanced ultrasonography with specific imaging phases.
- Histopathology revealed tumor cells with hyperchromatic nuclei and fibrous stroma structures.
- Immunohistochemistry was positive for markers like AE1/AE3, p40, CK5/6, c-kit, and NCAM.

## Abstract

Background and Clinical Significance: We present an 85-year-old male case of primary hepatic SCC manifesting as multiple liver nodules with atypical imaging findings. Case Presentation: The patient was negative for hepatitis B surface antigen and hepatitis C virus antibody. Serum tumor markers were all within normal limits. Contrast-enhanced ultrasonography with perflubutane demonstrated hypervascular nodules in the early vascular phase, early washout in the portal phase, and a defect in the postvascular phase (10 mm in S5 and 25 mm in S6). Histopathological examination revealed irregularly shaped tumor cells with large hyperchromatic nuclei and basophilic cytoplasm, surrounded by dense fibrous stroma forming cords, solid nests, and sheet-like structures. Immunohistochemical analysis showed positivity for AE1/AE3, p40, CK5/6, c-kit, and NCAM. Conclusions: The lesions were diagnosed as primary hepatic squamous cell carcinoma and suggested the possible involvement of hepatic progenitor cells, supporting the hypothesis of de novo carcinogenesis.