Primary Hepatic Squamous Cell Carcinoma: Diagnostic Dilemmas and Therapeutic Strategies in a Rare Liver Malignancy: A Case Report and Literature Review

Primary hepatic squamous cell carcinoma (SCC) is an exceptionally rare malignancy with vague clinical features and no characteristic biomarkers. We present a 64-year-old woman with right upper quadrant pain and significant weight loss, initially suspected to have a liver abscess. Imaging revealed hepatic masses, and biopsy confirmed SCC with no extrahepatic primary source. Immunohistochemistry supported a primary hepatic origin, and molecular profiling showed PD-L1 positivity. Despite palliative immunotherapy, the patient’s condition rapidly deteriorated. This case highlights the diagnostic challenges and limited therapeutic options in primary hepatic SCC, emphasizing the need for continued reporting and research.