Oral cavity & oropharynx
Oral cavity squamous cell carcinoma
Spindle cell
Author: Nat Pernick, M.D.
Topic Completed: 1 November 2013
Minor changes: 1 April 2021
Copyright: 2002-2021, PathologyOutlines.com, Inc.
PubMed Search: Spindle cell carcinoma[TI] oral
Table of Contents
Definition / general | Prognostic factors | Case reports | Treatment | Gross description | Microscopic (histologic) description | Positive stains | Differential diagnosisCite this page: Pernick N. Spindle cell. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityspindlecellcarcinoma.html. Accessed April 19th, 2021.
Definition / general
- Also called sarcomatoid carcinoma or carcinosarcoma
- Rare
- Mean age 50+ years, men with history of tobacco use, alcohol abuse, poor oral hygiene or prior radiation therapy
- Sites: vermillion border of lower lip, tongue, alveolar ridge and gingiva
- Metastases: have variable histology
- Highly aggressive, 61% mortality and mean survival 1 - 2 years
Prognostic factors
- Poor prognostic factors: local recurrence, cervical nodal metastases
Case reports
- 51 year old man with polypoid tongue tumor (Arch Pathol Lab Med 2001;125:433)
Treatment
- Surgery, often with radiation therapy
Gross description
- 2/3 appear as polypoid mass on mucosal surface, 1/3 are sessile or ulcerated
Microscopic (histologic) description
- Biphasic squamous cell carcinoma and malignant spindle cell stroma
- Larger tumor cells may have hyaline globules
- Malignant features may occur only at base of polypoid mass
- May be superficially invasive with no apparent connection to atypical spindle cells or a classic squamous cell carcinoma present deep within sarcomatoid component
- Has variable squamous and spindle cell differentiation with bone or cartilage; often resembles malignant fibrous histiocytoma
Differential diagnosis
- Radiation effect
- Reactive angiofibroblastic proliferations
- Sarcoma
