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Case Reports
. 2020 Nov 2;13(11):e236652.
doi: 10.1136/bcr-2020-236652.

Unique presentation of palatal metastasis from high-grade spindle cell sarcoma of the bone

Valentina Fenech  1 , Anton Queen  2 , Archana Gadve  2 , Fiona Cowie  2
Affiliations
Case Reports

Unique presentation of palatal metastasis from high-grade spindle cell sarcoma of the bone

Valentina Fenech et al. BMJ Case Rep. .

Abstract

Spindle cell sarcoma (SCS) is a rare malignant tumour which can arise in bone and accounts for 2%-5% of primary bone cancer cases. Distant metastasis occurs predominantly in the lungs. However, metastasis to the soft palate, to the best of our knowledge, has never been previously reported. In this case report, we describe a unique presentation of soft palate metastasis in a patient with a history of high-grade SCS of the bone who presented with progressive dysphagia and nausea and vomiting who underwent surgical excision for palliation of symptoms.

Keywords: ear; mouth; nose and throat; oncology; palliative procedures.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Intraoral examination of soft palate lesion.
Figure 2
Figure 2
Unenhanced CT image of soft palate lesion (*) in sagittal view measuring 22×16×20 mm (transverse×anteroposterior×craniocaudal) and separate from the base of the tongue.
Figure 3
Figure 3
Light microscope image of the soft palate lesion by H&E staining (magnification ×20) shows the tissue is composed of fascicles of spindle-shaped cells with abundant eosinophilic cytoplasm. There is moderate to marked nuclear pleomorphism and prominent mitotic activity, including the presence of abnormal mitosis.
Figure 4
Figure 4
IHC staining patterns of the soft palate lesion for SMA, CD34, AE1/3 and S-100. (A) Positive staining for SMA in the spindled tumour cells. (B) Negative staining of tumour cells for CD34 and evidence of CD34 uptake by normal blood vessel endothelial cells. (C) Negative staining of tumour cells for AE1/3. (D) Negative staining of tumour cells for S-100. The IHC staining patterns for desmin, MNF, CD31, CAM5.2 and caldesmon show identical features to microscopic images C and D. IHC, immunohistochemical; SMA, smooth muscle actin.
See this image and copyright information in PMC

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