Spindle cell lesions of the head and neck: an overview and diagnostic approach

Anderson, C; Al‐Nafussi, Awatif

doi:10.1016/j.mpdhp.2009.02.009

Cited by 33 publications

(34 citation statements)

References 90 publications

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“…Commonly it arises from larynx, nasal cavity, hypopharynx, oral cavity is rare site of presentation. 1 In present study most common site of primary tumor was oral cavity contrary to western data. Here tobacco chewing is more common habit rather than smoking this might be the probable cause of increase incidence of oral cavity carcinosarcoma.…”

Section: Discussion and Review Of Literaturecontrasting

confidence: 68%

“…1 It consists of epithelial and mesenchymal components hence diagnosis is challenging and complex, Monoclonal hypothesis has been proved by many studies that both components have the same monoclonal origin with transformation and dedifferentiation of epithelial cell to spindle cells supported by immunohistochemistry. 2,3 It usually occurs in males during 6 th and 7 th decades of life.…”

Section: Discussion and Review Of Literaturementioning

confidence: 99%

“…1 These tumors are biphasic and it have been proved by many studies that it evolves from conventional squamous carcinoma with dedifferentiation associated with sarcomatoid transformation. 2,3 Most commonly it arises from larynx, nasal cavity, hypopharynx, esophagus, trachea, oral mucosa.…”

Section: Introductionmentioning

confidence: 99%

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Carcinosarcoma of Head and Neck; Clinicopathological Characteristics, Treatment and Outcomes of Unique Neoplasm

Singh

Sharma

2017

IJRRT

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Background: Carcinosarcoma of the Head and neck is rare neoplasm with incidence of <1%. This is biphasic tumor with epithelial and mesenchymal components. Rarity of this neoplasm is major obstacle to establish proper guidelines. Only few case series and reports are available. Aim:The aim of this study was to evaluate clinicopathological characteristics, treatment and its outcome to contribute in part to the better understanding and awareness of this rare malignancy. Material and Methods:Retrospectively data of histological proven carcinosarcoma of head and neck from 2013 to 2015 was retrieved and evaluated for various parameters and also compared with both Indian and western data. Results:Total of 5 patients of carcinosarcoma were registered within selected timeframe. The mean age of 44.8years ranged from 27years to 68years. Male predominance was reported with M:F ratio 4:1.Oral cavity is most common site of tumor followed by oropharynx .Surgery is primary modality of treatment followed by adjuvant radiotherapy as per indication .Shortest follow up was 11month and longest was 31months. Only One patient was presented with recurrence. Conclusion:The diagnosis of carcinosarcoma is challenging so histopathology along with immunohistochemistry is needed for appropriate diagnosis. Oral cavity seems to be the most common site with younger age group in present study which is supported by other Indian studies. Future studies are needed to define the geographical variation with clinicopathological character as well as treatment protocol for this relatively rare entity.

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Section: Discussion and Review Of Literaturecontrasting

confidence: 68%

Section: Discussion and Review Of Literaturementioning

confidence: 99%

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Carcinosarcoma of Head and Neck; Clinicopathological Characteristics, Treatment and Outcomes of Unique Neoplasm

Singh

Sharma

2017

IJRRT

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“…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].…”

Section: Introductionmentioning

confidence: 99%

“…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]. They pose a significant diagnostic challenge to the pathologist with remarkable morphological and immunohistochemical overlap with other benign and malignant spindle cell tumors [1,3]. An accurate diagnosis of these tumors is essential as they vary in their clinical management and outcome [3].…”

Section: Introductionmentioning

confidence: 99%

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

Viswanathan

Rahman

Pallavi

et al. 2010

Head and Neck Pathol

170

177

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Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. This study evaluates their clinicopathologic characteristics in head and neck mucosal sites and the problems in distinguishing them from other spindle cell tumors. A total of 103 cases with a confirmed diagnosis of sarcomatoid carcinoma accessioned in the pathology department of a tertiary referral cancer centre over a period of 7 years (2004)(2005)(2006)(2007)(2008)(2009)(2010) were studied. An algorithm used for their diagnosis is presented. Ages of the patients were 22-90 years (median 53 years), and male:female ratio was 3.7:1. Site distribution was oral cavity (n = 65, 63.1%), larynx (18, 17.5%), oropharynx/hypopharynx (12, 10.7%), maxilla (6, 5.8%) and metastatic nodes (2, 1.9%). A large number of patients (95%) presented with a mass lesion of less than 1 year duration. Histopathologically, epithelial differentiation was evident on morphology in 48 (46.6%) cases, only on IHC in 34 (33%) cases, and in 21 (20.4%) no epithelial differentiation was seen. Typically, tumors were polypoidal (92, 89.3%) and ulcerated (95, 92.2%) with cells arranged predominantly in fascicles (59, 57.3%) or storiform pattern (17, 16.5%) amidst collagenous (50, 48.5%) or myxoid matrix (35, 34%). Anaplasia (2?/3?) and mitosis[10 per 10 HPF were noted in 96 (93.2%) cases. IHC was done in 82 cases; 55 (66.7%) showed positivity for epithelial markers with aberrant expression of mesenchymal markers in 43 (41.7%). Diagnosis of sarcomatoid squamous carcinoma is challenging because of overlapping histopathological features with other spindle cell tumors. Understanding their clinicopathologic characteristics facilitates their diagnosis and appropriate clinical management.

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