Spindle Cell Carcinoma of the Head and Neck: A Clinicopathological and Immunohistochemical Study of 40 Cases

Anupam Sarma, Rajjyoti Das, J. D. Sharma, A. C. Kataki

Department of Gynecologic Oncology & Director, Dr. B. Borooah Cancer Institute, Guwahati, India..
Department of Head & Neck Oncology, Dr. B. Borooah Cancer Institute, Guwahati, India.
Department of Pathology, Dr. B. Borooah Cancer Institute, Guwahati, India.

DOI: 10.4236/jct.2012.36137                

Abstract

Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins. Immunohistochemistry along with routine histopathology is essential in establishing the diagnosis of spindle cell carcinoma. We at Dr. B. Borooah Cancer Institute, Guwahati, a regional institute for treatment and research, hereby report 40 cases of such lesion with clinicopathological and immunohistochemical study. Out of total 40 cases included in the study group most of the cases were in the age group of 40 to 60 years. Commonest site of presentation was nasopharynx and buccal mucosa. 14 cases of the oral cavity (buccal mucosa, alveolus, oral tongue and hard palate) were treated with surgery. All the cases with disease of the larynx and hypopharynx were treated with radiotherapy and cases involving the nasopharynx received radiotherapy and chemotherapy. In the surgery group recurrence rate was found to be 71.4% and metastasis rate was 21.4%. Biopsy specimens were subjected to histopathological examination followed by immunohistochemistry. Immunohistochemical analysis show concurrent presence of malignant epithelial and sarcomatoid spindle cell components by co-expression of cytokeratin (CK) and vimentin to various degrees.

Keywords

Spindle Cell Carcinoma (SpCC); Squamous Cell Carcinoma (SCC); Immunohistochemistry (IHC)

Conflicts of Interest

The authors declare no conflicts of interest.

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