Spindle Cell Squamous Cell Carcinoma of the Tongue: A Rare Variant at an Even Rarer Location (original) (raw)
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Spindle cell carcinoma of the tongue: a rare variant of squamous cell carcinoma
Ecancermedicalscience, 2014
Spindle cell carcinoma (SpCC), a rare, aggressive variant of squamous cell carcinoma (SCC), is characterised by proliferation of epithelial and mesenchymal components. It is important to diagnose this variant of SCC, because of its tendency to recur and early metastasis. It accounts for 1% of all tumours in the oral cavity. In this paper, we have reported a case of SpCC of the tongue in a 65-year-old male who presented with a polypoidal growth over the lateral border of his tongue with a short history of one month. Immunohistochemical expression of cytokeratin was strongly positive in the epithelial component and focally in the spindle cell component. The spindle cell component showed a strong positivity for vimentin.
einstein (São Paulo), 2019
Spindle cell squamous cell carcinoma of the tongue is a rare variant of squamous cell carcinoma. This paper reports the case of a spindle cell squamous cell carcinoma of the tongue, in a 64-year-old male patient, and presents a review of the etiopathogenesis, clinicopathological and immunohistochemical features and treatment of the malignancy. The patient presented for evaluation of a painful swelling on his tongue. Extraoral examination revealed palpable submandibular and superior cervical lymph nodes. Based on the presumptive diagnoses of squamous cell carcinoma or malignant salivary gland neoplasm, an incisional biopsy was performed. Histopathological analysis showed a proliferation of atypical spindle cells, exhibiting extensive pleomorphism. Tumor cells were positive for vimentin, P53 and alpha-smooth muscle actin, focally positive for epithelial membrane antigen and P63, and negative for pan-cytokeratin (AE1/AE3), CK7, CD138, CD34, CD56, and S-100. The positivity index for Ki-67 was approximately 40%. The diagnosis of spindle cell squamous cell carcinoma was established and the patient was referred to a head and neck surgery service. In the oral cavity, spindle cell squamous cell carcinoma of the tongue is an aggressive variant of squamous cell carcinoma, which usually presents as an exophytic mass located on the tongue of elderly males. Due to its distinct histopathological characteristics, immunohistochemistry is a valuable and helpful tool to establish the diagnosis of spindle cell squamous cell carcinoma of the tongue.
Spindle cell carcinoma of the tongue: a case report in a young patient
Bioscience Journal, 2017
Spindle cell carcinoma (SpCC) is a rare biphasic tumor of epithelial origin that comprises squamous and sarcomatoid components. The diagnosis may be challenging, particularly when the squamous differentiation is not obvious. SpCC of the tongue has rarely been reported. Here we report a case of SpCC on the right border of the tongue of a 28-year-old male. The diagnosis was based on the correlation of clinical, morphological, and immunohistochemical findings. We describe this rare tumor, present at an unusual location in a young patient to contribute to better understanding and awareness of this rare malignancy.
Oral Spindle Cell Carcinoma –Diagnosis Based on Immunohistochemical Interpretation
Case Report, 2021
Abstract Spindle Cell Carcinoma (SpCC) is a biphasic tumor. They are proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. It is a rare tumor which is infrequently observed in head, neck and in the aerodigestive tract. The tumor is aggressive and shows high frequency of recurrence and metastasis. It is an aggressive variant of squamous cell carcinoma which resembles a true sarcoma. It is a proliferation of spindle cells and squamous cells. For confirmation of diagnosis, immunohistochemistry is used. A Rare case of spindle cell squamous cell carcinoma in a 61 years old male in the tongue.The patient reported of rapidly growing lesion from six months with pain severe pain, dysphagia and difficulty in swallowing patient had history of chewing tobacco from past 35 years. Keywords: Spindle Cell Variant, Biphasic tumor, Head and Neck, Pseudocarcinoma, Sqamous cell, Dysplastic.
Journal of Clinical Pathology, 2006
Background: Spindle cell carcinoma (SpCC) is a rare microscopic type of cancer of the mouth and oropharynx. Although SpCC is thought to arise from squamous cell carcinoma (SCC), it carries a worse prognosis. Aim: To find out the difference in immunohistochemical expression of cytokeratin, vimentin and smoothmuscle actin, and mutational alterations in the K-ras oncogene between the two tumours, in an attempt to characterise SpCC. Methods: Immunohistochemical analysis was performed by standard avidin-biotin complex method in 35 cases each of SpCCs and SCCs. DNA extracted from paraffin wax-embedded tumours was used for PCR followed by single-strand conformation polymorphism for mutational analysis of K-ras exon 1 and exon 2. Results: In the SpCC group, cytokeratin positivity was significantly higher in epithelial areas (52.2%) than in spindle cell areas (16.1%), whereas vimentin was more positive in spindle cell areas (18.7%) than epithelial areas (2.7%). Cells intermediate between epithelial and spindle cell areas were consistently positive for both cytokeratin and vimentin. Cytokeratin was found to be significantly more positive in SCC (72.6%) than the squamous component and spindle cell component of SpCC. In this study, no mutation was detected in the Kras gene of either the SpCC or SCC group. Conclusions: The spindle cell component of SpCC is intermixed with cells that are morphologically mesenchymal but express dual antigen-positivity characteristic of epithelial (cytokeratin) and mesenchymal (vimentin) cells. These, possibly, are cells in transition suggesting that SpCC may be a sarcomatous metaplasia of SCC.
Diagnostic Enigma of Spindle Cell Carcinoma of the Oral Cavity- Review of Literature
Acta Scientific Dental Scienecs, 2021
Spindle cell carcinoma is a variant of squamous cell carcinoma which has been reported in oral cavity with different demographic data. Spindle cell carcinoma has been addressed with various terminologies including, "sarcomatoid carcinoma", "collision tumor", "pseudocarcinoma" owing to its varied proposed histogenesis. Spindle cell carcinoma is important to understand due to its perplexing pathological diagnosis. The "dedifferentiating" epithelial population into spindle cell morphology leads to overlapping features with other sarcomatous tumors. It is essential to evaluate the lesion and attain a proper diagnosis for better treatment and clinical outcomes. Thus, in this review published literature and reported cases has been presented to understand such aggressive lesion with importance of using diagnostic techniques such as immunohistochemistry to understand the pathogenesis.
Spindle Cell Carcinoma of the Tongue: A Rare Tumor in an Unusual Location
Pathology Research International, 2011
Spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and mesenchymal components. Presence of this tumor type in the tongue has rarely been reported. Herein, a case of 55-year-old woman who presented with a polypoid lesion at her tongue has been reported. Surgery was performed and pathologic examination revealed a spindle cell carcinoma. We present this rare tumor with an unusual location to contribute in part to the better understanding and awareness of this rare malignancy.
Spindle Cell Carcinoma of the Oral Cavity: A Case Report of a Rare Entity and Review of Literature
World Journal of Dentistry, 2012
Spindle cell carcinoma is a rare and peculiar biphasic malignant neoplasm that occurs mainly in the upper aerodigestive tract. It consists of sarcomatoid proliferation of pleomorphic spindle cells and squamous cell carcinoma. It is considered potentially aggressive in its biological nature with a high incidence of metastases. We report a case of this tumor with an unusual clinical course. The histogenesis of the spindle cell component is discussed in detail in the review of literature.
Head and Neck Pathology, 2010
Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. This study evaluates their clinicopathologic characteristics in head and neck mucosal sites and the problems in distinguishing them from other spindle cell tumors. A total of 103 cases with a confirmed diagnosis of sarcomatoid carcinoma accessioned in the pathology department of a tertiary referral cancer centre over a period of 7 years (2004-2010) were studied. An algorithm used for their diagnosis is presented. Ages of the patients were 22-90 years (median 53 years), and male:female ratio was 3.7:1. Site distribution was oral cavity (n = 65, 63.1%), larynx (18, 17.5%), oropharynx/hypopharynx (12, 10.7%), maxilla (6, 5.8%) and metastatic nodes (2, 1.9%). A large number of patients (95%) presented with a mass lesion of less than 1 year duration. Histopathologically, epithelial differentiation was evident on morphology in 48 (46.6%) cases, only on IHC in 34 (33%) cases, and in 21 (20.4%) no epithelial differentiation was seen. Typically, tumors were polypoidal (92, 89.3%) and ulcerated (95, 92.2%) with cells arranged predominantly in fascicles (59, 57.3%) or storiform pattern (17, 16.5%) amidst collagenous (50, 48.5%) or myxoid matrix (35, 34%). Anaplasia (2?/3?) and mitosis[10 per 10 HPF were noted in 96 (93.2%) cases. IHC was done in 82 cases; 55 (66.7%) showed positivity for epithelial markers with aberrant expression of mesenchymal markers in 43 (41.7%). Diagnosis of sarcomatoid squamous carcinoma is challenging because of overlapping histopathological features with other spindle cell tumors. Understanding their clinicopathologic characteristics facilitates their diagnosis and appropriate clinical management.