Sarcomatoid carcinoma of the mandible: report of a case

Abstract

Sarcomatoid carcinoma is a rare and occurs mainly in the upper aerodigestive tract such as the oral cavity, esophagus and vocal cords. It is a unique variant of squamous cell carcinoma. We report the case of a patient with spindle cell squamous cell carcinoma involving the mandible. At initial examination, overlying mucosa of that lesion was normal appearance. One week later, that lesion showed ulcerative and bloody change and rapid growth in size. This case showed unpredictable rapid growth although rapid growth in size was suspected of undergoing malignancy.Key words: Sarcomatoid carcinoma, Mandible, Mandibular neoplasms [원고접수일 2010.3.15 / 1차수정일 2010.4.15 / 2차수정일 2010.4.29 / 게재확정일 2010.5.13] Abstract (J Korean Assoc Oral Maxillofac Surg 2010;36:228-30)

Sarcomatoid variant of squamous carcinoma in recurrent and second primary tumors of the oral cavity

“…Less than 1% of all tumors in the oral cavity are of a sarcomatoid differentiation, occurring from the 2nd to the 9th decade of life. 1,7,8,18 They have a predilection for the lower lip, tongue, and lower alveolar gingiva. 7,18 Their etiology has been suggested to be radiationinduced, trauma, tobacco use, and alcohol consumption, but cases without any relevant habitual history have also been reported.…”

“…1,7,8,18 They have a predilection for the lower lip, tongue, and lower alveolar gingiva. 7,18 Their etiology has been suggested to be radiationinduced, trauma, tobacco use, and alcohol consumption, but cases without any relevant habitual history have also been reported. 7 A unique feature of the sarcomatoid variant is a relative scarcity of the carcinomatous component that creates a dilemma in its histopathology diagnosis.…”

“…7,18 Their etiology has been suggested to be radiationinduced, trauma, tobacco use, and alcohol consumption, but cases without any relevant habitual history have also been reported. 7 A unique feature of the sarcomatoid variant is a relative scarcity of the carcinomatous component that creates a dilemma in its histopathology diagnosis. 1 This is often dependent on the site of biopsy, as if it is taken from squamous component it can be diagnosed as a carcinoma, whereas biopsies from the spindle component tend to misdiagnose it as a sarcoma.…”

“…1 This is often dependent on the site of biopsy, as if it is taken from squamous component it can be diagnosed as a carcinoma, whereas biopsies from the spindle component tend to misdiagnose it as a sarcoma. 7 The metastatic spread also occurs via the lymphatics and may contain pure epithelial, spindle, or a mixture of the two cell patterns. 19 In immunohistochemistry (IHC) studies, cytokeratin (CK) is considered the most reliable epithelial marker, but epithelial membrane antigen (EMA) and carcinoembryonic antigen (CEA) have also found to be useful.…”

“…Although considered by many authors to be ineffective, adjuvant radiotherapy has been shown to be an acceptable option to improve outcomes. 7,19 These recommendations are derived from studies that considered previously untreated cases. On studying a homogenous population of SPT and recurrent cases, we found that the salvage rates were higher in the SPT than recurrences.…”