• Lei Gao, Xiaolong Tang, Hui Qu, Qingsi He, Guorui Sun, Jingbo Shi, Jianhong Ye, and Yahang Liang.
• Qilu Medical College of Shandong University.
• Medicine (Baltimore). 2020 Sep 4; 99 (36): e22125.

RationalePrimary gastric squamous cell carcinoma (SCC) is rarely encountered clinically. SCC, which presents as a submucosal tumor, is even rarer. Without the support of pathological evidence, it is difficult to make a correct preoperative diagnosis. Due to limited clinical data, the pathogenesis and treatment of gastric SCC remain unclear.Patient ConcernsA 69-year-old man was admitted to our hospital with unexplained weight loss. Endoscopy revealed a submucosal mass without any ulcer on its surface located on the body of the stomach. The results of 2 gastroscopic mucosal biopsies were chronic inflammation.DiagnosesThe clinical diagnosis by computed tomography (CT) and gastroscopy was gastrointestinal stromal tumor (GIST) preoperatively. The postoperative pathological examination demonstrated this tumor as moderately differentiated SCC.InterventionsTotal gastrectomy, distal pancreatectomy, and splenectomy were performed.OutcomesThe patient was discharged 7 days after the surgery without any complications. The follow-up CT scan showed no evidence of metastatic disease 6 months after surgery.LessonsLarge primary gastric SCC could present as a submucosal mass. Gastroscopic mucosal biopsy may not be able to get tumor tissue due to inflammatory reaction.

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