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Adenosquamous carcinoma is a gallbladder cancer that mixes gland-forming and squamous (skin-like) cancer cells; pure squamous carcinoma is rarer still. These tumours are larger and more advanced when found and do worse than ordinary adenocarcinoma, but they are treated in the same way because no trial has studied them separately.
Squamous differentiation arises through metaplasia in the chronically inflamed gallbladder lining. A tumour is called adenosquamous when the squamous component exceeds 25 percent (Gasparello 2026); pure squamous cell carcinoma has no glandular component. In the National Cancer Database analysis of 13,158 patients, the 703 adenosquamous tumours (5 percent) were larger, more often poorly differentiated and more often stage III or IV (75 versus 69 percent), and overall survival was worse both overall and after curative-intent resection; adjuvant chemoradiation was associated with benefit (Murimwa 2021). A SEER series identified 388 patients between 1975 and 2018 and found surgery, node dissection, radiotherapy and chemotherapy each associated with better cancer-specific survival (Fang 2023). In a Chinese surgical series of 411 gallbladder cancers, 10 squamous and 24 adenosquamous tumours were all T3 or T4, with more T4 disease (61.8 versus 34.0 percent) and more node involvement (58.8 versus 39.0 percent) than adenocarcinoma; only complete (R0) resection gave one-year survivors (30 percent) (Song 2015). A 2026 molecular study of 25 European cases found PD-L1 positivity (combined positive score above 1) in 96 percent and claudin 18.2 expression in 28 percent (Gasparello 2026).
What differs in treatment: staging, surgery and chemotherapy follow the adenocarcinoma pathway (Cancer Research UK: treated in the same way as adenocarcinomas), but the expectation is of bulkier, more invasive disease, so complete resection is harder to achieve, and the high PD-L1 expression is a reason to study immunotherapy in this subtype specifically. No approved treatment is specific to it.
Around 5 percent: 703 of 13,158 gallbladder adenocarcinoma or adenosquamous cases in the US National Cancer Database 2004 to 2015 were adenosquamous (Murimwa 2021); Cancer Research UK puts squamous cell cancers at about 5 in 100.
Most pancreatic cancers arise in the head next to the bile duct, which is why jaundice is the presenting sign; bile duct cancers are named by where along the tree they sit.
Same organ: Glucagonoma, VIPoma, Somatostatinoma, Pancreatic ductal adenocarcinoma, Biliary tract cancer (cholangiocarcinoma), Intrahepatic cholangiocarcinoma, Extrahepatic cholangiocarcinoma (perihilar and distal), Biliary tract cancer (all types), Neuroendocrine tumours, Pancreatic neuroendocrine tumours, Grade 3 well-differentiated neuroendocrine tumour, Extrapulmonary neuroendocrine carcinoma, Gallbladder cancer, Gallbladder adenocarcinoma, Papillary carcinoma of the gallbladder, Mucinous carcinoma of the gallbladder, Neuroendocrine carcinoma of the gallbladder, Incidental gallbladder cancer (found after cholecystectomy), Carcinoma in situ and dysplasia of the gallbladder, Cystic duct carcinoma, Ampullary cancer (ampulla of Vater), Resectable pancreatic ductal adenocarcinoma, Borderline resectable pancreatic ductal adenocarcinoma, Locally advanced unresectable pancreatic ductal adenocarcinoma, Metastatic pancreatic ductal adenocarcinoma, KRAS G12C-mutant pancreatic ductal adenocarcinoma, KRAS wild-type pancreatic ductal adenocarcinoma, BRCA or PALB2-mutant pancreatic ductal adenocarcinoma, Mismatch repair deficient (MSI-high) pancreatic ductal adenocarcinoma, Pancreatic acinar cell carcinoma, Intraductal papillary mucinous neoplasm and other pancreatic cystic precursors, Pancreatoblastoma, Adenosquamous carcinoma of the pancreas, Colloid (mucinous non-cystic) carcinoma of the pancreas, Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells, Invasive carcinoma arising in an intraductal papillary mucinous neoplasm (IPMN-associated carcinoma), Mucinous cystic neoplasm of the pancreas with associated invasive carcinoma (MCN-associated carcinoma), Solid pseudopapillary neoplasm of the pancreas
As for gallbladder adenocarcinoma; complete resection is the only setting with long-term survivors in the surgical series, and adjuvant chemoradiation was associated with benefit in the National Cancer Database.
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Query for this cancer: (TITLE:"Adenosquamous and squamous carcinoma of the gallbladder" OR ABSTRACT:"Adenosquamous and squamous carcinoma of the gallbladder" OR TITLE:"Adenosquamous carcinoma of the gallbladder" OR ABSTRACT:"Adenosquamous carcinoma of the gallbladder" OR TITLE:"Squamous cell carcinoma of the gallbladder" OR ABSTRACT:"Squamous cell carcinoma of the gallbladder" OR TITLE:"Gallbladder cancer with squamous differentiation" OR ABSTRACT:"Gallbladder cancer with squamous differentiation") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Adenosquamous and squamous carcinoma of the gallbladder, not a curated reading list.
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Bleeding that does not stop by itself, bleeding from more than one site, or new bruising in several places or one large area.
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