Spindle cell hemangioma in the mucosa of the upper lip. Nov 15, 2019 the oral cavity is the primary entry point for exogenous substances into the body and home to the specialized tissues that help us chew, taste, speak, and express ourselves. May 28, 2008 spindle cell lesionsneoplastic or nonneoplastic. Spindle cell squamous carcinoma of the oral region. A comprehensive morphological and immunohistochemical analysis was done. We present a case of sch in the upper lip of a 41yearold woman. Spindle cell myoepithelial carcinoma of the oral cavitya. If it is single, look for local sources of irritation, such as cheek, tongue or lip biting. Pigmented lesions of the oral cavity pocket dentistry. The american college of surgeons commission on cancer and the american cancer. Electron microscopy often shows the presence of junctional complexes between tumor cells, with or without pericellular basal lamina and cytoplasmic skeins of intermediate filaments. The manifestation of mucosal pigment is variable and can range from focal to diffuse macular coloration or from a small nodular growth to a large mass. The most important reason is the presence of cytological atypia and mitosis in all three conditions. Pdf the spindle cell neoplasms of the oral cavity researchgate.
Multiple white lesions that do not rub off should be noted in patient records, including the location of the lesions. In the oral cavity some of the pigmented lesions are physiologic, but most are considered pathologic. Cancers from distant organs such as breast, lung and prostate may metastasize to the oral cavity. A 42yearold woman was referred to our department because of a painless swelling on the left. To date, 19 cases of imt have been described in the nasal cavity and maxillary sinuses, 4 nine have been described in the oral cavity with the mandible as the site of predilection, 5 and only a few well documented imts have been found in the larynx. Nonsquamous cell malignant tumours of the oral cavity. Originally presented on february 09, 2015 in park city, utah. Spindle cellcarcino ma spcc, a subtype of squamous cell carcinoma scc, recurs and metastasizes more frequently, and is associated with a worse prognosis than scc. Spindle cell carcinoma spcc is an unusual subtype of squamous cell carcinoma with an aggressive behavior. Nodular fasciitis nf is a benign reactive soft tissue lesion that was. Differential diagnosis of white lesions of the oral cavity evaluate the mouth to see if the white lesion is single or multiple.
Cleveland clinic foundation, institute of pathology, cleveland, oh 44195, usa. Differential diagnosis of laryngeal spindle cell carcinoma. Differential diagnosis of white lesion of oral cavity. Contents introduction causes for development of spindle cell tumors various classifications proposed for spindle cell lesions clinical and histological features of. Spindle cell myoepithelial carcinoma of the oral cavitya report of. Spindle cell lipoma scl is an uncommon and histologically distinct variant of lipoma, initially described by enzinger and harvey. Spindle cell carcinoma spcc is a unique and challenging variant of squamous cell carcinoma scc. The intriguing array of spindle cell lesions occurring, especially in the head and neck region. The workup of spindle cell lesions of the breast requires the judicious use of immunohistochemical stains to arrive at the correct diagnosis, especially on coreneedle biopsy. The major challenge in the diagnosis of such lesions is good clinicopathological correlation as the differential diagnosis of spindle cell lesions is vast and needs ihc confirmation. Pdf classification of giant cell lesions of the oral. Presence of this tumor type in the tongue has rarely been reported. This classification was based on the predominance of spindle cells in the histopathology of the lesions of the oral cavity.
Spindle cell carcinoma consists of dominant spindle shape cells together with in situ or ductal, lobular, squamous, or mixed infiltrating carcinoma. Spindle cell lesions of the breast university of utah. May 05, 2014 spindle cell neoplasms can affect the oral cavity and it is often very difficult for the oral pathologists to differentiate it from other similar microscopic simulates. While some are malignant, others are benign or simply reactive in. We report two cases of laryngeal spindle cell tumors. Sarcomatoid carcinoma of the oral cavity comprises less than 1% of all tumors of the oral cavity. The diagnosis and management of giant cell lesions of the jaws anthony m pogrel department of oral and maxillofacial surgery, university of california san francisco, san francisco, ca, usa. Spindle cell carcinoma of the nasal cavity semantic scholar. The nature of various oral granular cell lesions is unclear, and many theories have been proposed for the origin of granules, the principal ones are odontogenic, fibroblastic, histiocytic, myoblastic, and neurogenic. Here we present two such cases of spindle cell myoepithelial carcinoma, which were. Spindle cell myoepithelial carcinomas need to be differentiated from other spindle cell lesions of the oral cavity like sarcomatoid squamous carcinoma, melanoma, nerve sheath sarcoma, etc.
Jul 21, 2014 spindle cell carcinoma spcc, a rare, aggressive variant of squamous cell carcinoma scc, is characterised by proliferation of epithelial and mesenchymal components. Pigmented lesions of the head and neck t here is a wide spectrum of pigmented lesions which present an oral mucosa or skin in the head and neck area. Histologically, the mucosal surface may be intact, hyperplastic, or ulcerated the majority of spindle cell lesions presenting at uadt but without dysplasia. Tumours and tumourlike lesions of the oral cavity composed predominantly of granular cells are uncommon. This paper presents a brief overview of nonsquamous cell oral.
Cytopathology of spindle cell lesions of soft tissue and bone. Spcc confined solely to the nasal cavity is extremely rare, with only one case having been. A new case of a 71yearold man with an asymptomatic buccal mucosal lesion is. The occurrence of this tumor in maxillary sinus has rarely been reported. M y presentation of carcinoma of the oral cavity will tend to be of the most practical kind, and it aims to bring about a better understanding be tween you who look at it from the stand point of the dental surgeon and myself, a dermatologist interested in carcinoma of the mucous membranes. In the upper aerodigestive tract, similar to conventional scc, spcc occurs most commonly in the larynx. Spindle cell carcinoma of the nasal cavity sachin gupta. August 4, 2016these lesions must be differentiated from the papillaryverrucous lesions, whose appearance is often white or white and red, is shown in this section and for which there is a different flowchart. A rare spindle cell neoplasm bernardoferreira brasileiro 1, pauloricardosaquete martinsfilho 1, martarabello piva, luizcarlosferreira da silva 1, cassianofranciscoweege nonaka 2, marciacristinada costa miguel 2 1 department of oral pathology, dentistry school, federal university of sergipe, sergipe. Spindle cell neoplasms can affect the oral cavity and it is often very difficult for the oral pathologists to differentiate it from other similar microscopic simulates. The nf should be included in the clinical differential diagnosis of superficial and deep soft tissue masses of the oral cavity, especially of the buccal mucosa. Oct 29, 2016 the identification of pigmented tissue within the oral cavity may present a diagnostic dilemma for the clinician. The author suggests that prophylactic complete neck dissection would not seem to be indicated in cases of cancer of the floor of the mouth without clinical involvement of regional nodes. Pdf spindle cell carcinoma of the oral cavity researchgate.
Case 1 is a spindle cell carcinoma spc in a 55 yearold male patient and case 2 an inflammatory myofibroblastic tumor imt in a 34 yearold female patient. Spindle cell lipoma scl is a benign lipomatous neoplasm typically located in the posterior neck and back of older males. Inflammatory myofibroblastic tumour of paranasal sinuses with. The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic resonance imaging. Summarymyoepithelial carcinomas are not as rare as is generally believed, but they are simply not well recognized. The purpose of this paper is to discuss the clinical and histological. The floor of the mouth is an uncommon site for scl, and very few cases. The major challenge in the diagnosis of such lesions is good clinicopathological correlation as the differential diagnosis of spindlecell lesions is vast and needs ihc confirmation. Seminar on spindle cell tumors of the oral cavity part i by.
Spindle cell myoepithelial carcinoma of the oral cavitya report of two cases shubhada v. Spindle cell soft tissue neoplasms are rarely reported in the oral cavity and account for less. Pseudovascular adenoid squamouscell carcinoma of the oral. However, the relative rarity of spindle cell rms in oral cavity, presence of striated. Multiple mott cells in periapical lesion of the oral cavity. Forty cases of oral spindle cell lipoma have been reported in the literature. Seminar on spindle cell tumors of the oral cavity part ii by. Thermal burns to the oral mucosa are fairly common, usually due to contact with very hot foods, liquids, or hot metal objects. Spindle cell carcinoma of maxilla journal of oral and maxillofacial. Laryngeal lesions, in particular, are mucosal sites. Introduction spindle cell lesions affecting oral mucosa are quite diverse in nature and their diagnosis is always a challenge.
The most common malignant spindle cell tumor was ks, but other malignancies were rare. Spindle cell lipoma oral cavity lipoma spindle cell neoplasm benign oral abstract the spindle cell variant is a histologic subtype of lipoma that is rarely found in the oral cavity. Spindle cell carcinoma of the oral cavity and oropharynx. Two cases of pseudovascular adenoid squamouscell carcinoma scc in the oral cavity are described, which were characterised by acantholysis of the tumour cells, with formation of anastomosing spaces and channels mimicking an angiosarcoma. Spindle cell lipoma of the mandibular mucogingival junction. Informed consent was obtained for the publication of the patients details in this report. The entities, both benign and malignant, that compose the spindle cell lesions of the breast will be discussed. Spindle cell myoepithelial carcinoma of the oral cavity a. Spindle cell lesions of the breast are rare entities. We provide an overview of the lesions with a spindle cell morphology that may be encountered in this region and detail a histological. It is typically exophytic or nodular with smooth differential diagnosis of mucosal spindle cell lesions masses projecting into the lumen. Aug 09, 2017 spindle cell lesions of oral cavity part ii 1. Recommend this article send to my kindle download citation.
Gastrointestinal tract spindle cell lesionsjust like real estate, its all about location. Benign spindle cell tumour of mandible and points of modification in reconstruction with nonvascularised iliac crest graft suresh vyloppilli, benny joseph, k. Oct 18, 2018 pigmented lesions of the head and neck t here is a wide spectrum of pigmented lesions which present an oral mucosa or skin in the head and neck area. White lesions caused by biting generally occur along the occlusal line. The incidence of nf in the oral cavity is very rare and it occurs mostly in. Spindle cell carcinoma spcc is a rare and unusual biphasic. Reactive nodules of the oral cavity are fairly common and are a diverse group. Spindle cell lesions of soft tissue and bone encompass a wide spectrum of benign and malignant conditions. The spindle cell neoplasms of the oral cavity ncbi. Spindle cell hemangioma sch is a unique benign vascular lesion. It is important to diagnose this variant of scc, because of its tendency to recur and early metastasis. The most common fibrous proliferative lesions of the oral cavity are fibroma 61%, peripheral ossifying fibroma 22%, pyogenic granuloma 12%, and peripheral giant cell granuloma.
Granules in granular cell lesions of the head and neck. The diagnosis and management of giant cell lesions of the. The differential diagnosis of lesions or abnormalities of the oral cavity will help nondental healthcare providers hcps to refer atrisk patients to the appropriate provider so they can be reexamined more closely. The differential diagnosis of lesions or abnormalities of the. Aug 09, 2017 spindle cell lesions of oral cavity part i 1. They include reactive lesions such as granulomatous inflammation, pseudosarcomas such as nodular fasciitis, benign mesenchymal tumors such as neurofibroma and schwannoma, low and highgrade sarcomas, spindle cell carcinoma, and spindle cell melanoma. Oral spindle cell carcinomas usually are treated by surgical resection, alone or combined with. Histopathologically, nf should be differentiated from other spindle cell lesions, mainly myofibroma, neurofibroma, fibrosarcoma, solitary fibrous tumor, fibromatosis and. A report of spindle cell carcinoma in maxillary sinus. The mass developed 5 years earlier and enlarged after repeated ethanol injections. It is most frequently encountered in the larynx, and also occurs in the nasal cavity, hypopharynx, oral cavities, esophagus, trachea, skin and breast. In the oral cavity, the origin of the spindle cell neoplasms may be traced to epithelial, mesenchymal and odontogenic. The second case had originally been reported as atypical spindle cell neoplasm, but, after immunohistochemistry revealed keratin expression, the diagnosis was revised to spindle cell scc.
Bagwan a, tanuja shet a, prashant bavi a, anil dcruz b a department of pathology, tata memorial hospital, dr. However, there are a number of entities that have a predilection for the gingivae, which are much less common in other parts of the oral cavity. Spindle cell carcinoma of the breast japanese journal of. Annals of diagnostic pathology 2009 173 175 radiologicpathologic correlation suprasellar spindle cell lipoma krista l. Spindle cell carcinoma an overview sciencedirect topics. It has spindled or pleomorphic tumor cells which simulate a true sarcoma but of epithelial origin 2. It usually occurs as a solitary, subcutaneous, and wellcircumscribed lesion in the posterior neck, shoulders, and back of older men. In the oral cavity, the origin of the spindle cell neoplasms may be traced to epithelial, mesenchymal and odontogenic components. Spindle cell carcinoma spcc, also known as sarcomatoid carcinoma, is a rare malignancy of the head and neck regions. Spindle cell lipoma scl is a rare variety of lipoma that mostly arises in male patients and rarely affects the oral cavity. We report a case of spindle cell lipoma of the cheek.
In the presence of clinically positive cervical nodes, a monoblock resection with a radical neck dissection is employed. Differential diagnosis for spindle cell lesions presenting at uadt. In the head and neck region, the two most important malignancies which can present with this appearance are spin. The diagnosis of lesions with spindle cell morphology is often difficult. All suspicious lesions, however, should be examined by biopsy. Spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and mesenchymal components. Pdf benign spindle cell tumour of mandible and points of.
Oral nodular fasciitis a case report with a diagnostic schema. Ernest borges road, parel, mumbai400017, maharashtra, india b department of surgery, tata memorial hospital, parel. Spindle cell carcinoma is an unusual neoplasm commonly observed in the oral cavity and the larynx. Case report dermatofibrosarcoma protuberance of the oral. Although more common in other sites in the body, spindle cell neoplasms are rare in the oral cavity, as this study has shown. Oral cavity anatomical and physiological specificities. This case report describes the diagnosis, management, and followup of a 35yearold female, who presented with spindle cell carcinoma of maxillary sinus.
In a previous series of laryngeal malignancy, about 1%. Those arising in the oral cavity and exhibiting pure spindle cell morphology are often difficult to diagnose primarily and are likely to be misinterpreted as other more common spindle cell lesions of the oral cavity. Gastrointestinal tract spindle cell lesionsjust like real. Those arising in the oral cavity and exhibiting pure spindle cell morphology are often. In some cases, the dignity is difficult to determine. The high prevalence of ks in this series is likely reflective of demographics unique to the san francisco bay area. Two autopsy cases are presented of spindlecell carcinoma of the oral cavity, which were. A 4cm lesion was resected from the gastric antrum of a 56yearold. However, on rare occasions it occurs in the breast 3,4. Hence, we made an attempt to categorize round cell tumors of the oral cavity in table 1 based on the predominance of round cells in the histopathology of the lesions of the oral cavity. It accounts for 1% of all tumours in the oral cavity.
Differential diagnosis of the spindle cell lesions in the oral cavity includes benign and malignant fibrous histiocytoma, demoplastic melanoma, schwannoma, leiomyosarcoma, kaposis sarcoma and haemangiopericytoma. Lesions of the gingivae are amongst the commonest lesions seen in patients and the vast majority are reactive hyperplasias, related to a number of chronic irritant stimuli. Red lesions of oral cavity authorstream presentation. International journal of contemporary medicine surgery and radiology. Carcinoma of the oral cavity by lester hollander, m. May be superficially invasive with no apparent connection to atypical spindle cells or a classic squamous cell carcinoma present deep within sarcomatoid component has variable squamous and spindle cell differentiation with bone or cartilage. Pdf on jan 1, 2017, pournima godge and others published spindle cell carcinoma of the oral cavity find, read and cite. Clinicopathological and immunohistochemical analysis of spindle. It presents as a wellcircumscribed mass in the buccal mucosa, tongue. For biopsies from the head and neck assessment is further complicated by the range of tissues present at this site, and the limited amount of material which may be available for study. It has a wide age of occurrence ranging from 2nd to 9th decade and a mean age during the 5th decade with a predominant male predilection 3, 4.