Spindle cell carcinoma of the gingiva: report of an autopsy case

Abstract

An autopsied case of an 80‐year‐old man with spindle cell carcinoma of the gingiva is reported. The tumor was polypoid and mostly composed of a sarcomatous proliferation of spindle cells with a small focus of squamous cell carcinoma at the stalk portion. The carcinoma metastasized to a cervical lymph node, lungs and pleura with extension to the diaphragm. In the metastatic lymph node, the squamous cell component was more prominent than the spindle cell one, while only anaplastic pleomorphic carcinoma cells were found in the lungs. The spindle or anaplastic cells were immunohistochemically positive for vimentin and carci‐noembryonic antigen (CEA) but not for other epithelial antigens. We have concluded that the sarcomatoid component arose from the oral squamous cell carcinoma by a metaplastic process. This is the first case report of an oral spindle cell carcinoma examined by autopsy.

Keratinized Spindle Cell: A Diagnostic Cytological Atypia In Human Oral Carcinoma

“…The presence of junctional complexes between tumor cells, with or without pericellular basal lamina and cytoplasmic skeins of intermediate filament has been demonstrated [20]. It has been suggested that development of the spindle cell phenotype involves functional loss of genes that control epithelial differentiation and that conversion to spindle morphology is a recessive entry [21]. It has been documented that keratin proteins may be regarded as molecular markers for stratified squamous epithelial cells in normal tissues and in neoplasms.…”

Sarcomatoid (Spindle Cell) Carcinoma of the Head and Neck Mucosal Region: A Clinicopathologic Review of 103 Cases from a Tertiary Referral Cancer Centre

“…The degree of mesenchymal metaplasia within the tumor may vary widely and may be seen as bony or cartilagenous elements within the tumor or as aberrant immunohistochemical marker expression [2][3][4][5][6][7][8][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32]. Although no aberrant metaplastic elements were observed in any of our cases, we did see aberrant expression of vimentin, calponin, SMA, desmin and S100 protein, which is also well reported in literature [3].…”

“…Sarcomatoid (spindle cell) carcinomas of the head and neck are unusual variants of squamous carcinoma commonly reported in the larynx but also described in other mucosal sites such as gingiva, tongue, hypopharynx and nasal cavity [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. These tumors have now been proved to be monoclonal, evolving from conventional squamous carcinoma with dedifferentiation associated with sarcomatoid transformation [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32].…”

Sarcomatoid carcinoma of the mandible: report of a case

“…A tumor of the oral cavity and oropharynx is potentially aggressive and seems recur easily and to metastasize easily 9 . The incidence of metastases was 36% and the 2-year survival rate was 55% in tumors involving the oral cavity 1 .…”

“…It is a unique variant of squamous cell carcinoma consisting of sarcomatoid proliferation of plemorphic spindle-shaped cells sometimes with a biphasic appearance presenting as a part of frank squamous cell carcinoma 1,2 . This type of carcinoma has been described using various terms, including spindle cell squamous carcinoma, carcinosarcoma, pseudosarcoma, and pleomorphic carcinoma1.…”