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Case Reports
. 2022 Jul 23;14(7):e27175.
doi: 10.7759/cureus.27175. eCollection 2022 Jul.

Second Primary Spindle Cell Carcinoma of the Tongue: A Rare Histology

Lalchhandami Colney  1 , Chinmayee Panigrahi  2 , Mahesh Sultania  1 , Amit Kumar Adhya  2
Affiliations
Case Reports

Second Primary Spindle Cell Carcinoma of the Tongue: A Rare Histology

Lalchhandami Colney et al. Cureus. .

Abstract

Spindle cell carcinoma (SpCC) is a rare variant of poorly differentiated squamous cell carcinoma (SCC), characterised by the presence of both squamous (carcinomatous) and spindle cell (sarcomatous) elements. Early detection and improvement in treatment for oral SCC lead to prolonged survival, thereby increasing the frequency of second primary tumours (SPTs) in the oral cavity. In this paper, we report a case of SpCC of the tongue in a 62-year-old male with a history of SCC; the right lateral border of his tongue status post-treatment completion four years ago, now presented with a polypoidal growth over the tip of his tongue for four months. An immunohistochemical study revealed features suggestive of SpCC (spindle cell pattern of cells, expression of vimentin, immunopositivity for cytokeratin (membranous), and focally positive for p40 (nuclear)). To the best of our knowledge, this is the first reported case of a spindle cell variant of SCC presenting as a second primary in an oral cancer survivor patient.

Keywords: head and neck squamous cell cancer; oral cancer pathology; second primary malignancy; spindle cell mesenchymal tumor; tongue neoplasm.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Second Primary Spindle Cell Carcinoma Tongue
(A) Polypoidal growth at the tip of the tongue. (B) Gross photograph of the tumor, showing a polypoidal fleshy growth with a stalk attached to the tip of the tongue. The surface is ulcerated, and the cut surface is soft, grayish-white with focal hemorrhages. (C) Photomicrograph showing surface ulceration and a spindle cell tumor; H & E stain, 40×. (D) Photomicrograph showing spindle cell tumor, the tumor cells show moderate nuclear pleomorphism, vesicular chromatin, and brisk mitosis; H & E stain, 400×. (E) The tumor cells are immunopositive for pancytokeratin, indicating its epithelial differentiation, 400×. (F) Tumor cells are immunopositive for p40, indicating its squamous differentiation, tumor cells were negative for S-100, SMA, Desmin, CD34, and Bcl2, 400×.
See this image and copyright information in PMC

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