Primary gastric squamous cell carcinoma of indeterminate origin managed by laparoscopic multivisceral resection: a case report

Primary squamous cell carcinoma (SCC) of the stomach is an exceptionally rare tumor, comprising <0.5% of gastric malignancies. Diagnosis requires strict histopathologic and immunohistochemical confirmation to distinguish it from adenosquamous carcinoma or esophageal extension. We report a 30-year-old woman with chronic anemia and recurrent upper gastrointestinal bleeding. Endoscopy revealed a large gastric polypoid lesion, and computed tomography showed an exophytic mass invading the pancreatic tail and spleen. The patient underwent total gastrectomy with distal pancreatectomy, splenectomy, and colectomy, initiated laparoscopically and converted to open surgery for <i>en bloc</i> resection. Histopathology confirmed a moderately differentiated pure squamous carcinoma with lymphovascular and perineural invasion. Despite postoperative complications, the patient recovered after multiple re-explorations. This case underscores the diagnostic challenge and clinical significance of primary gastric SCC, highlighting the importance of accurate identification to guide appropriate surgical management.