Spindle cell carcinoma is an uncommon variant of squamous cell carcinoma that occurs in several subsites in the head and neck 14. Download cancer stem cells in solid tumors pdf the cancer stem cell hypothesis postulates that cancer arises from a subpopulation of tumor initiating cells or cancer stem cells cscs. There is generally a biphasic pattern in varying proportions consisting of a spindle cell component with tapered nuclei set in a. Spindle cell lipoma may be difficult to distinguish from a malignant tumor. Spindle cell lesions of the head and neck are quite diverse with great clinical and biological heterogeneity. Spindle cell lesions can occur in head and neck skin, in the soft tissues of the scalp, orbit, and neck, and along the upper aerodigestive tract uadt mucosa. Request pdf spindle cell lesions of the head and neck.
Characteristically, the lesion appears as a large, gray, polypoid tumor. The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic. For biopsies from the head and neck assessment is further complicated by the range of tissues present at this site, and. Spindle cell carcinoma of the head and neck is a rare neoplasm. The term spindle cell lesion, or tumor, is a purely descriptive one and if applied without further. Oral cavityoral mucosahead and necksynovial sarcomadiagnosis. A diagnosis of a soft tissue sarcoma, and a myofibrosarcoma in particular, was made via biopsy. Pseudosarcoma, initially considered a benign response of connective tissue to an adjacent squamous carcinoma, is now regarded as a spindle cell variant of epidermoid carcinoma.
Spindle cell squamous cell carcinoma of skin may appear as skin lesions, commonly on sunexposed areas, mostly the head and neck region. Cureus a vascularappearing spindle cell xanthogranuloma. Nine cases of spindle cell carcinoma of the larynx are presented. Spindle cell lesions of head and neck include a diverse group of clinically and biologically heterogeneous lesions. Spindle cell lipomas scl may have minimal or no visible fat on mr or ct.
Two cases of spindle cell carcinoma of the head and neck. Epidermal growth factor receptor expression in spindle. Spcc is extremely rare in the head and neck region, especially in the paranasal sinuses. Pdf sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of. The tumor was composed of sheets of large round to oval cells with pleomorphic vesicular nuclei, prominent nucleoli and abundant eosinophilic cytoplasm.
Abstract we report a case of basaloid squamous carcinoma of the hypopharynx with an extensive spindle cell component in an 82yearold man. Myod1 l122r mutations are associated with spindle cell. It is a biphasic tumor consisting of the combination of a malignant mesenchymal spindle cell component and a squamous cell component that includes dysplasia, carcinoma in situ, or invasive carcinoma. Spindle cell carcinoma, spindle cell lesions, head and neck. Local recurrence rates are reported as high as 70 per cent of cases, the recurrence of desmoid fibromatosis in the head and neck is difficult to ascertain because of the different classification schemes used by different authors. Epidermal growth factor receptor egfr is expressed by 90 % of conventional scc, and high level expression is associated with a poorer prognosis.
Spindle cell lipoma an overview sciencedirect topics. Diagnostic challenging lesions in head and neck pathology. Synchronous glottic granular cell tumor and subglottic. Examples include dermatofibrosarcoma protuberans, desmoplastic melanoma, malignant fibrous histiocytoma, leiomyosarcoma, malignant peripheral nerve sheath tumor, and spindle cell squamous cell. Our understanding of adipocytic tumors classification and diagnosis continues to evolve.
The region commonly referred to as the head and neck includes the upper aerodigestive tract oral cavity, paranasal sinuses, pharynx, larynx, cervical esophagus, thyroid, associated lymph nodes, soft tissues, and bone. Cutaneous spindle cell carcinoma describes a heterogenous group of tumors that share an atypical spindle cell morphology and infiltrative growth pattern. Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. This study evaluates their clinicopathologic characteristics in head and neck mucosal sites and the problems in distinguishing them from other spindle cell tumors. Clinicopathological and immunohistochemical analysis of spindle. Spindle cell lipoma most commonly presents as a subcutaneous nodule in the head and neck region of. The patient was followed up for a period of three months, during which he was symptom free. We report two cases of spindle cell carcinoma spcc, one of the maxillary sinus and another of the larynx. Scl may be bright on t2 resembling a cystic or myxoid tumor. Clinicopathological and immunohistochemical analysis of. Spindle cell carcinomas of the head and neck rarely harbor. Lynne p taylor alyx b porter umphrey alyx b porter. Pediatric myofibromatosis of the head and neck pediatric. The nccn guidelines panel for cervical cancer screening endorses the following guidelines for the prevention and early detection of cervical cancer.
We report 24 desmoid tumors of the head and neck and propose a reasonable approach in the management of such cases. Post irradiation spindle cell carcinoma of tonsillar pillar. Cutaneous spindle cell squamous carcinoma is an uncommon variant of squamous cell carcinoma, in which a keratinocytes infiltrate dermis as single cells with elongated nuclei, not as cohesive nests or islands, and b there are no minimal signs of keratinization of conventional squamous cell carcinoma am j dermatopathol 2008. Spindle cell carcinoma pseudosarcoma of the larynx. Seminar on spindle cell tumors of the oral cavity part i by. In the head and neck region, the two most important malignancies which can present with this appearance are spindle cell squamous carcinoma and malignant melanoma. Lms can include preexistent structures appearing freefloating. Pdf on nov 16, 2017, ali dehghani nazhvani and others published cytokeratin. These tumors arise mostly in the head and neck and, in childhood, represent the largest subset of soft tissue tumors. Careful analysis of the available data deemed laryngeal and hypopharyngeal verrucous scc, spindle cell scc, and basaloid scc to be non. Spindle cell melanoma refers to invasive melanomas in which the tumor is. Fibrosarcoma of the head and neck has been reported to occur rarely in infants and children. Here, we show that sublethal doses of cisplatin may. Basaloid squamous carcinoma of the hypopharynx with an.
Spindle cell lipomas are composed of two cell types. Spindle cell neoplasms can affect the oral cavity and it is often very difficult for the oral pathologists to differentiate it from other similar microscopic simulates. Malignant lesions with spindle cells arranged into fascicles were considered, as both tumours. We present a case of sch in the upper lip of a 41yearold woman. Spindle cell carcinoma spcc, also known as sarcomatoid carcinoma or pseudosarcoma, of head and neck is a rare neoplasm. Distribution of spindle cell lesions in head and neck, 20042010 n 171. Solitary fibrous tumor of the head and neck sciencedirect. Download cancer stem cells in solid tumors pdf download.
Our ucni brain tumor specialists final pdf free download. Usually there is a relatively even mixture of these components, but there is considerable variation in individual tumors. There is no evidence in this case that suggests malignant transition of the granular cell tumor to malignant tumor. Epithelium mesenchyme both odontogenic tumors epithelium origin tumor 1 ameloblastoma. The world health organization who system for defining and classifying soft tissue tumors is usually applied to lesions that occur in the trunk and extremities, but it also provides an excellent framework for characterizing nonepithelial extraskeletal tumors of the head and neck. Immunohistochemistry along with routine histopathology is essential in establishing the diag. Pigmented lesions of the head and neck pdf free pdf epub. Sarcomatoid spindle cell carcinoma of the head and neck.
It has been reported that the larynx, oral cavity, and pharynx are the sites of predilection of this cancer in the head and neck. Pdf sarcomatoid spindle cell carcinoma of the head and neck. Three patients in the present series were initially diagnosed. While the idea of cancer stem cells has been around for more than a hundred years, evidence from the fields of hematology. Spindle cell squamous cell carcinoma of skin dovemed. For the practicing pathologist, knowledge of these established and emerging entities is critical for the correct pathologic diagnosis and treatment of the patient. Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. However, preclinical studies of how antitumor immunity in hnscc is affected by cisplatin alone or in combination with immunotherapies are lacking.
The histological diagnosis of spindle cell lesions can be challenging in any. Laryngeal spindle cell carcinoma spcc is an uncommon subtype of squamous cell carcinoma which represents 0. Some are malignant while many others are benign or simply reactive in nature. In the oral cavity some of the pigmented lesions are physiologic, but most are considered pathologic. Abstractspindle cell carcinoma spcc is a rare and unusual biphasic malignant tumor, which involves. Smears from myoepithelial carcinoma may show spindle plasmacytoid cells but an oncocytic cell type has also been described. Perivascular and vascular neoplasms of the head and neck are a rare group of tumors. Article information, pdf download for recurrent spindle cell carcinoma. Spindle cell carcinoma spcc is an uncommon head and neck squamous cell carcinoma scc variant consisting of spindled andor pleomorphic cells with epithelial differentiation. Although pleomorphic lipoma is a benign tumor, it may contain atypical cells. Skeletal muscle tumors are classified into rhabdomyoma and embryonal, alveolar, spindle cell sclerosing and pleomorphic rhabdomyosarcoma according to who classifications of tumors. The major who changes include refined terminology of existing entities, descriptions of new tumor types, elimination of defunct categories, and updated biological characterization of various tumor types. Pdf diagnostic challenging lesions in head and neck. Pathology outlines spindle cell squamous cell carcinoma.
Some tumors have almost no mature fat, and these relatively fat free tumors can cause diagnostic difficulty. Free download navigating life with a brain tumor ebooks pdf author. As a variant of spindle cell lipoma, pleomorphic lipoma clinically. Primary histiocytic sarcoma arising in the head and neck. In the oral cavity, the origin of the spindle cell neoplasms may be traced to. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins. A 41yearold nonsmoking caucasian man presented in june 2007 with a painless swelling under his tongue.
The head and neck is an embryologically and anatomically complex area, with a number of important structures and organs lying in close proximity to one another. Spindle cell carcinoma is a rare biphasic malignant neoplasm which is composed of both malignant epithelial and malignant mesenchymal elements. A case of fatfree pleomorphic lipoma occurring in the upper back. Spindle cell neoplasms are defined as neoplasms that consist of spindle shaped cells in the histopathology. For biopsies from the head and neck assessment is further complicated by the range of tissues present at this site, and the limited amount of material which may be available for study. Diagnostic approach to synovial sarcoma of the head and neck. Spindle cell xanthogranuloma is a rare variant of juvenile xanthogranuloma that most commonly presents in adults as papulonodules.
The diagnosis of lesions with spindle cell morphology is often difficult. Spcc is known as a high malignant variant of squamous cell carcinoma, which is composed of conventional squamous cell carcinoma component, either insitu andor invasive and malignant spindle component with sarcomatous appearance. Updated who nomenclature of head and neck lesions and. Myoepithelial carcinoma an overview sciencedirect topics. Multinucleated forms, numerous mitoses, and tumor necrosis were also. Desmoid tumors are rare benign tumors but have a tendency toward local recurrence after resection because of their infiltrative growth and frequent entrapment of vital structures in the head and neck region. Solitary fibrous tumor sft is an uncommon benign spindle cell neoplasm first described by klemperer and rabin in 1931 from 5 primary tumors of the pleura.
Spindle cell rhabdomyosarcoma of the head and neck is a very rare tumor in adults. Pigmented lesions of the head and neck t here is a wide spectrum of pigmented lesions which present an oral mucosa or skin in the head and neck area. We report the clinicopathologic findings in a case of coexistent glottic granular cell tumor and subglottic spindle cell carcinoma. Sitewise, the tumors occurred in the head and neck region, 11 paratesticular region. The patient is diseasefree at present 3 years after the initial diagnosis and is on regular followup. These tumors are histologically diverse and are classically characterized by a biphasic morphologic appearance with both sarcomatoid spindle cell and conventional squamous cell carcinoma components. Spindle cell hemangioma in the mucosa of the upper lip.
The lesions may ulcerate and cause scarring of skin the treatment of choice is a surgical excision with clear margins followed by radiation therapy or chemotherapy, as decided by the healthcare provider. We at kyushu cancer center experienced 6 cases of spindle cell carcinoma which accounted for 0. It was excised endoscopically, and the patient was free of disease after 2 years of followup. The mass developed 5 years earlier and enlarged after repeated ethanol injections. Aggressive fibromatosis of the head and neck desmoid. The cytoplasm is basophilic and often vacuolated fig. Spindle cell lesions of the head and neck region are. Antiegfr therapies are commonly used to treat head and neck. The most common site of origin in head and neck region is larynx particularly vocal cords. Spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and.
American cancer society, american society for colposcopy and cervical pathology, and american society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer. Spindle cell lesions of the head and neck are quite diverse with great. Spindle cell hemangioma sch is a unique benign vascular lesion. This study investigated a case of spindle cell carcinoma spcc in tongue pathological lesions.
This is the first case report of histiocytic sarcoma hs with predominant spindle cell component occurring in the head and neck region of a 41yearold man. The diverse tissues in this anatomic region give rise to a broad spectrum of tumors and tumor like conditions. Spindle cell carcinoma spcc is a rare and unusual biphasic. A diagnostically challenging spindle cell carcinoma of the. We describe a vascularappearing case of spindle cell xanthogranuloma on the nose of a 10yearold boy. Download tumor markers pdf ebook tumor markers tumor markers ebook author by eleftherios p. Our patient was free of lymph node metastasis but mandibular bone was invaded. Head and neck squamous cell carcinoma hnscc has been treated for decades with cisplatin chemotherapy, and antipd1 immunotherapy has recently been approved for the treatment of this disease. An adult spindle cell rhabdomyosarcoma in the head and. Cisplatin alters antitumor immunity and synergizes with pd.