Unusual recurrent tongue spindle cell carcinoma with marked anaplasia occurring at the site of glossectomy for a well-differentiated squamous cell carcinoma: A case report

Abstract

Abstract. Spindle cell carcinoma (SpCC), which predominantly arises in the oral, pharyngeal and laryngeal mucosal tissues, is composed of a mixture of squamous and sarcomatoid components. The present study describes the case of a 62-year-old woman with SpCC recurrence 4 years after an initial surgery to remove a well-differentiated primary squamous cell carcinoma (SCC) of the tongue. The recurrent tumor was spherical and located deep within the tongue tissue, which differs from the typical manifestation of ulcerated masses of the mucosa. The majority of cases of recurrence involving SpCC are associated with radiotherapeutic treatment of the primary malignancy; however, the patient in the present study had not received postoperative radiotherapy for SCC. Furthermore, the recurrent tumor in the present case exhibited marked anaplasia and sarcomatoid features, and the absence of SCC elements upon biopsy rendered histological diagnosis difficult. In summary, the present findings suggest that immunohistochemical examination and identification of SCC components are essential for ensuring the accuracy of the histological diagnosis of recurrent SpCC following a primary epithelial malignancy.

Comprehensive analyses of intraoral spindle cell carcinoma: A rare disease entity revisited

“…Among 69 cases included, clinical symptoms of intraoral SpCC were heterogeneous. Most patients presented as rapidly growing mass with ulcerated surface with complaints such as odontalgia, tooth mobility, limited mouth‐opening, and increasing dysphagia (Okuyama et al, 2017; Shibuya et al, 2000). Systemic symptoms, for instance, generalized weakness, weight loss, abdominal pain, anemia, and fever were complained by selected patients (Howard et al, 2007; Shibuya et al, 2000).…”

“…Twenty‐four cases had cervical lymph node metastasis upon treatment (Bavle et al, 2016; Jayaram & Elsayed, 2005; Kato et al, 2010; Munakata et al, 1998; Ohba et al, 2015; Ramesh et al, 2019; Reyes et al, 2015; Shigeta et al, 2015; Stojadinovic et al, 2002; Su et al, 2006; Wen‐cheng et al, 2005). Thirteen patients had a prior history of cancer, and 8 patients had prior oral SCC (Gorsky & Epstein, 1998; Kato et al, 2010; Okuyama et al, 2017; Xie et al, 2017). Particularly, two patients had multiple oral SCC recurrences before they were diagnosed with intraoral SpCC (Kato et al, 2010; Xie et al, 2017).…”

“…Thirteen patients had a prior history of cancer, and 8 patients had prior oral SCC (Gorsky & Epstein, 1998;Kato et al, 2010;Okuyama et al, 2017;Xie et al, 2017). Particularly, two patients had multiple oral SCC recurrences before they were diagnosed with intraoral SpCC (Kato et al, 2010;Xie et al, 2017).…”

Post-radiotherapy recurrence of conventional oral squamous cell carcinoma showing sarcomatoid components: an immunohistochemical study

“…We also conducted a literature review considering recurrence in cases of SpSCC in the head and neck region and other information such as demographic data, primary tumor, location, treatment, and time of recurrence. 7,9,10,[27][28][29][30][31][32][33][34] In most cases, the location of recurrence and the initial site of involvement were the same. The initial treatment most commonly used was a combination of surgery and radiotherapy, and surgery alone was often associated with recurrence.…”

A Case of Spindle Cell Squamous Cell Carcinoma Manifesting in the Mandible Following Resection of Buccal Mucosal Squamous Cell Carcinoma

“…Spindle Cell Squamous Cell Carcinoma (SpC-SCC) is identified as a pernicious variant of squamous cell carcinoma, typified by its highly malignant nature and the manifestation of sarcomatoid changes, primarily characterized by spindle-shaped cells. While numerous instances of SpC-SCC post-radiation therapy or chemotherapy for squamous cell carcinoma have been documented [1][2][3][4][5], the emergence of SpC-SCC subsequent to surgical resection remains a notably rare phenomenon [6]. In this report, we present an exceptional case where partial resection of the buccal mucosa, inclusive of the mandibular periosteum, was necessitated due to the invasion of buccal mucosal cancer into the mandibular gingival mucosa.…”