Oral cavity & oropharynx

Oral cavity squamous cell carcinoma

Spindle cell



Topic Completed: 1 November 2013

Minor changes: 1 April 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: Spindle cell carcinoma[TI] oral

Nat Pernick, M.D.
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Cite this page: Pernick N. Spindle cell. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/oralcavityspindlecellcarcinoma.html. Accessed December 2nd, 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
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
Positive stains
Differential diagnosis
  • Radiation effect
  • Reactive angiofibroblastic proliferations
  • Sarcoma
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