The characteristic spindle cell phenotype of the neoplastic cells in SpCC is the result of epithelial-mesenchymal transition. The former component may be very scant or limited to noninvasive areas of epithelial dysplasia or carcinoma in situ located at the surface of the tumor, and its identification may require extensive sampling for histologic examination. Spindle cell carcinoma is a type of cancer which usually originates in the connective tissues of the body. SpCC also shows features of epithelial-mesenchymal transition, e.g., up-regulation of transcription repressors (Snail, Slug, SIP and Twist etc.) Sun exposure should be limited during the brightest period the day, which is generally between 11 in the morning and three in the afternoon. Moreover, foci of osteoblastic or chondroblastic differentiation (both benign and malignant) sometimes are observed.355,359,362,363 There may be sharp borders between SCC areas and the spindle cell component, but a gradual transition, with SCC cells “dropping off” from the epithelial nests or overlying squamous epithelium into the pleomorphic spindle cell areas, frequently may also be observed.352,359, Ultrastructural examination may reveal epithelial features such as desmosomes or tonofilaments in the spindle cells.356,359 More easy to employ is immunohistochemistry, by which expression of epithelial markers can be analyzed (Fig. Concerning age and sex, no differences between SpCC and conventional SCC have been reported. In a cancer stem cell population, planar spindle orientation with symmetric cell division could increase the number of cancer stem cells by producing identical daughter cells with cancer stem cell phenotypes. Sixty percent of 53 patients with tumors of the oral cavity died within 1 month to 6 years, 77% of 13 patients with tumors of the sinonasal tract died within 6 months to 2.5 years, and 34% of 65 patients with tumors of the larynx died within 4 months to 2 years. Any sores that do not heal with proper treatment within three to four weeks should be examined by a doctor. Pulmonary Spindle Cell Carcinoma is classified as a sarcomatoid carcinoma of lung, which are aggressive tumors, along-with pleomorphic carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma; Spindle Cell Carcinoma of Lung is a type of sarcomatoid carcinoma that can develop anywhere in the lung. Polypoid glottic tumors appeared to have the most favorable prognosis (90% 3-year survival rate), whereas patients with supraglottic, hypopharyngeal, sinonasal, and oral SpCCs did poorly regardless of their tumor's gross appearance. Spindle cell sarcoma is a type of cancer which occurs on the connective tissues of the body. Microscopic examination exhibits a proliferation of invasive spindle cells, typically accompanied by a squamous epithelial component (consisting of dysplastic surface epithelium, carcinoma in situ, or conventional invasive squamous cell carcinoma). The patient may complain of swelling, pain, paresthesia, persistent ulceration, or bleeding. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. URL: https://www.sciencedirect.com/science/article/pii/B9780128012383650924, URL: https://www.sciencedirect.com/science/article/pii/B9780323552257000105, URL: https://www.sciencedirect.com/science/article/pii/B9780123864567040016, URL: https://www.sciencedirect.com/science/article/pii/B9781416039662000175, URL: https://www.sciencedirect.com/science/article/pii/B9781416025894000024, URL: https://www.sciencedirect.com/science/article/pii/B9781416040590500199, URL: https://www.sciencedirect.com/science/article/pii/B978032349714500003X, URL: https://www.sciencedirect.com/science/article/pii/B9780323547239000099, URL: https://www.sciencedirect.com/science/article/pii/B9781437726077000336, Modern Surgical Pathology (Second Edition), 2009, Brad W. Neville DDS, ... Angela C. Chi DMD, in, Color Atlas of Oral and Maxillofacial Diseases, Human Papillomavirus and Epstein–Barr Virus in Head and Neck Lesions, Modern Surgical Pathology (Second Edition), Squamous Cell Carcinoma of the Upper Aerodigestive System, Diagnostic Surgical Pathology of the Head and Neck (Second Edition), Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas (Second Edition), Adrián Mariño-Enríquez MD, PhD, Jason L. Hornick MD, PhD, in, Practical Soft Tissue Pathology: a Diagnostic Approach (Second Edition), Endoscopic Ultrasonography in the Evaluation of Posterior Mediastinal Lesions. {"}Spindle cell{"} is a descriptive phrase that denotes the cellular shape of many of the sarcomas encountered in the adult population. It may quickly spread from one tissue system to another, making it harder to treat. They are found both in normal, healthy tissue and in tumors. However, if SpCC occurs intraosseously,366 its distinction from sarcomas with a spindle cell appearance may be extremely difficult or even impossible if immunohistochemistry or electron microscopy fail to reveal epithelial characteristics (Fig. It is more common in areas that have been exposed to the sun, although this is not always the case. The exact treatment options used and in what order will depend on the type of tissue being infected, as some respond better to radiation than chemotherapy. Only two cases had detectable HPV RNA, only one of which was strongly p16-positive. Spindle cell carcinomas, although fundamentally differentiating into epithelial cells, lose much of these features and gain some features of mesenchymal cells. Because these tumors demonstrate prominent exophytic growth with less extension into the esophageal wall, they have been associated with relatively good survival rates. Moreover, the observation that stromal fibroblasts as well as endothelial cells may both show these atypical changes may be helpful in distinguishing between SpCC and SCC with atypical stromal features (Fig. The name “spindle cell” comes from the shape the cells appear to have when viewed through a microscope. Cytokeratin expression can be demonstrated in spindle cells in 40%–85% of cases. spindle cell carcinoma A carcinoma—often squamous cell—which can occur on any epithelial surface (e.g., oral, anorectal, bladder, etc). The diagnosis of this condition may be challenging. Most cancers made up of spindle cells are called sarcomas. Spindle cell squamous carcinoma (SpCC) is an exceedingly rare variant of squamous cell carcinoma (SCC) with unique clinicopathological characteristics. Mitotic figures are usually limited. The growth pattern and cytomorphology are key features to help determine the line of differentiation of a spindle cell neoplasm. Spindle Cell Squamous Cell Carcinoma (SCC) of Skin is a malignant tumor of skin that is typically seen with a higher frequency in immunosuppressed individuals. These data strongly argue that transcriptionally active HPV is rare in these tumors and, thus, not a significant contributor to their development or outcomes. Brad W. Neville DDS, ... Angela C. Chi DMD, in Color Atlas of Oral and Maxillofacial Diseases, 2019. Macroscopically, SpCC may be a polypoid tissue mass or a fungating or ulcerated lesion not different from conventional SCC (Fig. The tumor can arise anywhere within the upper aerodigestive tract, with a predilection for the larynx and oral cavity. Spindle cell carcinoma is an unusual variant of SCC where part, or all, of the tumor resembles a sarcoma (Figure 28). In some studies, 50% to 60% of affected patients are alive after 5 years.1, Adrián Mariño-Enríquez MD, PhD, Jason L. Hornick MD, PhD, in Practical Soft Tissue Pathology: a Diagnostic Approach (Second Edition), 2019. They most commonly arise in patients over the age of 40 and are extremely rare - making up just 2-5% of all primary bone cancer cases. It is important to discover spindle call sarcoma in the first stage as it can easily be treated … Both were T4 tumors and had poor outcomes. 2-31). The converse situation, granulation tissue mimicking SpCC, may occur after ionizing-radiation exposure. Therefore, they have to be considered a variant of SCC in which the pleomorphic component originates through dedifferentiation of the SCC component.353–360 Molecular pathology has recently provided convincing proof of an evolution of the sarcomatoid component from the conventional one.360 Metastasis is to the cervical lymph nodes; the deposits may exhibit conventional SCC, SpCC, or both together.355,357,361,362, An SpCC typically occurs in the oral cavity and the larynx355,362; less frequently, it may arise in the sinonasal area and pharynx. Microscopically, the SCC component may be well-, moderately- or poorly differentiated, keratinizing or nonkeratinizing, and transition between the two components may be abrupt or gradual. Once the cancer has spread to other areas, symptoms can include fatigue, nausea, pain, and bruising. Oscar Lopez‐Nunez, Lea F. Surrey, Rita Alaggio, Karen J. Fritchie, Ivy John, Novel PPP1CB‐ALK fusion in spindle cell tumor defined by S100 and CD34 coexpression and distinctive stromal and perivascular hyalinization, Genes, Chromosomes and Cancer, 10.1002/gcc.22844, 59, 8, (495-499), (2020). Thompson, in Head and Neck Pathology (Second Edition), 2013. Immunohistochemically, tumor cells in SpCC often express epithelial and mesenchymal markers. If such tumors are less cellular, they may mimic benign reactive lesions. Within the oral cavity, frequently involved sites include the tongue, gingiva/alveolar mucosa, buccal mucosa, floor of the mouth, and lip. Therefore, discerning this lesion from SpCC should not be too problematic. J.S. (a) Polypoid and ulcerated tumor consisting of sheets of malignant spindle cells with moderate amounts of eosinophilic cytoplasm. Wikibuy Review: A Free Tool That Saves You Time and Money, 15 Creative Ways to Save Money That Actually Work. The cells show mild to moderate nuclear pleomorphism, with large, round to oval nuclei with pale to vesicular-appearing chromatin, distinct but small nucleoli, and abundant eosinophilic cytoplasm with indistinct cell borders (syncytial arrangement; Figure 24-89). 2-33). Smoking or chewing tobacco, sun exposure, alcohol use, and exposure to certain chemicals may raise the risk of developing this and other types of cancer. One of the main symptoms of the disease is a mass or tumor on the skin, sometimes resembling an ulcer or sore. Spindle cell carcinoma is a type of cancer which usually originates in the connective tissues of the body. Nodular fasciitis may exhibit mitotic figures, but they are not atypical; moreover, no cellular pleomorphism is present. Based on its clinical appearance, sometimes the tumor may be mistaken for a fibroma or other benign lesion. Very rare RMS with epithelioid and spindle cell morphology, female predominance, marked osseous predilection, ALK expression, EWSR1/FUS-TFCP2 gene fusions, and highly aggressive clinical behavior have recently been recognized with only 23 cases reported in the English language literature. However, these cells are dispersed among a non-neoplastic background and not densely packed in whorls of fascicles as in SpCC, which identifies them as part of a stromal reaction. The most sensitive and reliable epithelial markers to be used for demonstration of the epithelial phenotype are keratin (AE1/AE3), K1, K18, and epithelial membrane antigen.359 Moreover, double-labeling has indicated keratin and vimentin in individual spindle cells,356 thereby illustrating the versatility of the intermediate filament phenotype. Vascular invasion may be seen. Once the cancer spreads into surrounding organs or tissue, it is often much harder to treat. Lymphocytes and plasma cells may be present. Pieter J. Slootweg, Mary Richardson, in Diagnostic Surgical Pathology of the Head and Neck (Second Edition), 2009, Spindle cell carcinoma (SpCC), also called pseudosarcoma, sarcomatoid SCC, “collision” tumor, or sarcomatoid carcinoma, is a biphasic tumor composed of SCC cells and pleomorphic spindle-shaped cells.352 Since its original description, several theories have been forwarded regarding the significance of the pleomorphic cells.353,354 These cells represent either non-neoplastic bizarre stromal areas, metaplastically altered SCC cells, or cells of a separate mesenchymal neoplasm that forms a collision tumor with the SCC component, for which the term carcinosarcoma is employed. Spindle cell carcinomas are characterized by a proliferation of spindle cells with varying degrees of atypia and mitotic activity, often exhibiting transitions with areas displaying the features of conventional spindle cell thymoma. Spindle cell (sarcomatoid) carcinoma of the breast is a rare variant of breast cancer that has been classified under the broad rubric of metaplastic carcinoma. Spindle cell carcinoma exhibits a predilection for older adult males, with a peak in the fifth and sixth decades. Key features assisting in differentiating SpCC from the inflammatory myofibroblastic tumor are the absence of dysplastic or carcinomatous epithelial components, lack of dropping off from the overlying squamous epithelium, and no atypical mitotic figures.367, Sometimes, UADT mucosal melanomas may present as polypoid masses composed of pleomorphic spindle cells. There is a component of SCC in situ at the base of the polypoid mass (arrow) confirming this to be a carcinoma and not a true sarcoma (2 ×). Distinguishing between monophasic SpCC and spindle cell sarcomas such as fibrosarcoma and leiomyosarcoma may be more difficult. It is therefore the general view, that a malignant spindle cell tumor in the mucosa of the larynx tract is probably a SpCC and not a sarcoma. Although reported survival rates vary, one recent study based on epidemiologic data from the United States reported 5-year disease-specific survival of 39% for spindle cell carcinoma of the oral cavity. Spindle cell carcinomas occur at every head and neck subsite but have a predilection for the oral cavity and larynx. Typically, spindle cell carcinoma can occur in any connective tissue in the body, although it is more common in some areas than others. It is a very aggressive form of cancer, and patients who are diagnosed generally do not live more than five years. SETTLE: This is a highly cellular biphasic tumor showing primitive thymus histology, characterized by an admixture of spindle-shaped cells that merge with epithelial cells (Figure 24-86). Sunscreen should be used any time one is out in the sun, not only during the summer months. (A) Small islands and cords of squamous cell carcinoma and dense proliferation of neoplastic spindle cells. The cells are spindled, simulate a sarcoma (but stain for cytokeratin), and usually are more aggressive than non-spindle cell carcinomas. Keywords: Spindle-cell carcinoma, Second primary tumor, Synchronous cancer I. Eating a healthy diet and maintaining a proper weight and activity level may help to reduce the risk of spindle cell carcinoma along with other diseases. Various factors result in spindle cell carcinoma, including genetic predisposition, injury and inflammation. Cytokeratin and vimentin coexpression has been observed in individual tumor cells. Sometimes, only spindle cells are present. Several other terminologies have also been used including polypoid squamous cell carcinoma, … Introduction Spindle cell carcinoma (SpCC) is a rare type of squamous cell carcinoma (SCC) consisting of poorly differentiated elongated epithelial cells that show sarcoma-like proliferation 1 . 2-34). Risk factors for spindle cell carcinoma of the upper aerodigestive tract include tobacco use, alcohol consumption, and previous radiotherapy. The name of these often ends in “sarcoma.” Storiform or giant cell areas may also be present. De très nombreux exemples de phrases traduites contenant "spindle cell carcinoma" – Dictionnaire français-anglais et moteur de recherche de traductions françaises. From: Modern Surgical Pathology (Second Edition), 2009, Nina Zidar, Nina Gale, in Encyclopedia of Cancer (Third Edition), 2019. 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