Tumors composed of benign spindle cells, with variable lines of differentiation first described by toker cancer 1981. Spindle cell lesions are seen frequent enough that one ought to have a solid approach to em a general introduction to spindle cells is found in the spindle cell article. Spindle cell lesions of the head and neck are quite diverse with great clinical and biological heterogeneity. The pathology came back stating it is a spindel cell tumor. The head and neck is an embryologically and anatomically complex area, with a number of important structures and organs lying in close proximity to one another. Spindle cell lesions of thespindle cell lesions of the prostate j. Montone,1 zubair baloch,1 madalina tuluc,2 and virginia livolsi1 background. There is usually a recent history of trauma or surgery, and there is a predilection for flexor surfaces near joints and the abdominal wall. Spindle cell hemangioma hemangioendothelioma of the head. Thyroid gland solitary fibrous tumor lester dr thompson, md. Spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and mesenchymal components.
Sep 12, 2012 one challenging feature of head and neck pathology is that a dizzying array of spindle cell lesions occur here ranging all the way from reactive to malignant and very aggressive. The diagnosis of lesions with spindle cell morphology is often difficult. Case 1 66yearold, male was initially diagnosed as having squamous cell carcinoma scc of the maxillary sinus ct4an2cm0. A taper gradually decreases toward one end of the crosssection or width. The histological diagnosis of spindle cell lesions can be challenging in any. Molecular aspects of head and neck squamous cell carcinoma. These masses typically arise in males aged 4070 years and originate most frequently in the subcutaneous tissue of the upper back, posterior neck, and shoulders. Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. Professor of pathology and translation molecular pathology section chief of breast pathology 23rdannual seminar in pathology outline morphologic features of spindle cells lesions differential diagnosis case presentations wide spectrum bland, low grade spindle cells. Spindle cell lipoma typically occurs in the posterior neck, shoulder and back, and less commonly in a wide range of other locations. Spindle cell lipomas scl are relatively rare, slow growing, benign lipomatous tumors. The lesions may ulcerate and cause scarring of skin the treatment of choice is a surgical excision with clear margins followed by radiation therapy or chemotherapy, as decided by the healthcare provider. These markers can be used to assess the cellular lineage and histogenic origin of various neoplasms. The most common spindle cell lesion presenting along the uadt mucosa is spindle cell carcinoma spcc, which has many unique and challenging clinical and pathologic features.
Less common sites include the face, buccal cavity, scalp. The purpose of this study was to investigate the ct and mr imaging features of scl in the head and neck. Canine basal cell tumors most commonly develop in middleaged to older dogs. Combining five major spcc clinicopathologic studies, 18% of the 326. Spindle cell carcinoma, also termed carcinosarcoma, pseudosarcoma, polypoid carcinoma, sarcomatoid carcinoma, and spindle cell variant of squamous cell carcinoma, is a rare type of malignant tumor that often grows as an exophytic polypoid lesion see also chapter 20.
Spindle cell squamous cell carcinoma of skin may appear as skin lesions, commonly on sunexposed areas, mostly the head and neck region. Spindle cell carcinoma spcc, also known as sarcomatoid carcinoma or pseudosarcoma, of head and neck is a rare neoplasm. Spcc is extremely rare in the head and neck region, especially in the paranasal sinuses. May 28, 2008 spindle cell lesions of the head and neck are quite diverse with great clinical and biological heterogeneity. Some are malignant while many others are benign or simply reactive in nature. Spindle cell pleomorphic lipoma occurs almost exclusively in the subcutaneous tissue of the posterior neck and shoulder area.
The three lesions presented in this reportsarcomatoid carcinomas, nodular fasciitis, and fibrosarcomaserve to illustrate this point. At mucosal sites, the most important of these is spindle cell carcinoma spcc. Spindle cell carcinoma an overview sciencedirect topics. We provide an overview of the lesions with a spindle cell morphology that may be encountered in this region and detail a histological. Diagnostically relevant molecular markers in head and neck.
Webpathology is a free educational resource with 10304 high quality pathology images of benign and malignant neoplasms and related entities. Solitary myofibroma is a rare benign spindle cell neoplasm that may arise in the skin, subcutis, soft tissue, bone, and, exceptionally, in viscera. In literature the treatment of spindle cell sarcoma follows same footsteps as that of squamouscell carcinoma of similar stage with wide surgical excision being the preferred choice of treatment table 1. Many breeds are predisposed, especially wirehaired pointing griffons and kerry blue and wheaten terriers. These tumors are found most commonly on the head especially the ears, the neck, and forelimbs. Although both luminal epithelial and myoepithelial cells may assume spindle shapes, spindle cell lesions of the breast usually refer to conditions that are composed of mesenchymal or mesenchymallike cells that harbour elongated and stretched cytoplasm. Spindle cell pleomorphic lipoma, 28 spindle cell and pleomorphic lipoma represent the ends of the morphological spectrum of a single entity, distinct from atypical lipomatous tumors. Tumor markers are grouped into diagnostic and prognostic markers.
Spindle cells definition of spindle cells by medical. Aug 22, 2010 a total 171 cases of spindle cell tumors were reported over 7 years from 2004 to 2010, out of which 103 cases with a confirmed diagnosis of sarcomatoid squamous carcinoma were included in the study. May 19, 2017 spindle cell neoplasms are defined as neoplasms that consist of spindle shaped cells in the histopathology. Lowgrade sarcomas with cd34positive fibroblasts and low. Two cases of spindle cell carcinoma of the head and neck. In some cases, the dignity is difficult to determine. A comprehensive morphological and immunohistochemical analysis was done.
Spindle cell neoplasms are defined as neoplasms that consist of spindleshaped cells in the histopathology. We report two cases of laryngeal spindle cell tumors. They are usually well circumscribed and based in subcutaneous tissue but purely dermal tumours also occur histology of spindle cell lipoma. 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. Rid lhih d idl llresidual high grade spindle cell sarcoma, most cw malignant sft, involving bladder neck and extendinggp, into perivesical tissues, but all resection margins negative. Cutaneous spindle cell squamous carcinoma is an uncommon variant of squamous cell carcinoma, in which a keratinocytes infiltrate dermis as single cells with elongated nuclei, not as cohesive nests or islands, and b there are no minimal signs of keratinization of conventional squamous cell carcinoma am j dermatopathol 2008.
Spindle cell lesions can occur in head and neck skin, in the soft tissues of the scalp, orbit, and neck, and along the upper aerodigestive tract uadt mucosa. Oral surgery, oral medicine, oral pathology, oral radiology and endodontology. Specific diagnostic markers appear extensively in cells of a particular neoplasm and not in other tumors. Spindle cell lipomas have a wide variety of appearances. Immunohistochemistry along with routine histopathology is essential in establishing the diag. They are common in dogs, uncommon in cats, and rare in large animals. Aug 22, 2010 sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. Elucidating the dermal spindle cell and other cutaneous. Spcc is known as a high malignant variant of squamous cell carcinoma, which is composed of conventional squamous cell carcinoma component, either insitu andor invasive and malignant spindle component with sarcomatous. The most common site of origin in head and neck region is larynx particularly. A little over a week ago, i had surgery to remove a mass from my groin area. The entities, both benign and malignant, that compose the spindle cell lesions of the breast will be discussed. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins.
We report two cases of spindle cell carcinoma spcc, one of the maxillary sinus and another of the larynx. 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. Collagenous nevi are benign, focal, developmental defects associated with increased deposition of dermal collagen. This study evaluates their clinicopathologic characteristics in head and neck mucosal sites and the problems in distinguishing them from other spindle cell tumors. Solitary painless cutaneoussubcutaneousmucosal nodule, head and neck or lower extremity of adults well circumscribed but unencapsulated multinodular, biphasic tumors primitive cellular proliferation of small short spindle cells with thin walled branching blood vessels and whorled nodulesfascicles of plump spindle cells. Ct n 5 and mr n 3 images of seven patients five men and two women. Differential diagnosis of laryngeal spindle cell carcinoma. Nevertheless, in comparison to squamous cell carcinoma, within the head and neck region, spindle cell carci. They range from lesions which are mainly adipose tissue with scant spindle cell areas to those with very little fat and predominantly spindled cells fat free variant. 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 117. Spcc is known as a high malignant variant of squamous cell carcinoma, which is composed of conventional squamous cell carcinoma component, either insitu and or invasive and malignant spindle component with sarcomatous appearance.
He referred me to meet with an oncologist this week before coming back to him for my postsurgical appt. Cellular scars are intradermal fibroblastic myofibroblastic lesions characterized by nodules of spindle cells orientated in various directions, without nuclear atypia or pleomorphism efigs. Pashaei and colleagues describe a case of superficial leiomyosarcoma and discuss the differentiating histologic and immunohistologic features to distinguish the entity from other histologically similar cutaneous spindled neoplasms, such as atypical fibroxanthoma, spindlecell melanoma, and spindlecell squamous carcinoma. Pathology outlines spindle cell squamous cell carcinoma. Tumors of the mammary gland, afip atlas of tumor pathology, series 4, first edition, 2009. Solitary fibrous tumor of the spinal cord radiology. What is a spindle cell lesion with occasional mitotic. This chapter considers diagnosis of common spindle cell lesions predominantly occurring in dermis and superficial subcutis. The important diagnostic issues include 1 distinguishing spindle cell squamous cell carcinoma and malignant melanoma from true sarcoma, 2 discriminating between benign spindle cell lesions and malignancies, and 3 classifying histologic types and subtypes. Presence of this tumor type in the tongue has rarely been reported. Pathology outlines benign stromal spindle cell tumors bssct. Spindle cell tumours can be benign suffix oma or malignant suffix sarcoma, and will arise from these different cell lines. Pleomorphic cell tumors of soft tissue with pictures. Solitary fibrous tumors of the spinal cord are uncommon spindle cell neoplasms of probable mesenchymal origin, most commonly arising from the spinal cord without dural attachment they are histologically identical to solitary fibrous tumors located elsewhere, most commonly arising from the pleura the remainder of this article largely focuses on solitary fibrous tumors arising.
The name spindle cell refers to the shape of the cell on cytology and histology. The variable presentations of anaplastic spindle cell. In 1976, hawk and hazard described the tall cell variant tcv of papillary thyroid carcinoma. Spindle cell lesions of thespindle cell lesions of the prostate. These tumors have now been proved to be monoclonal, evolving from conventional squamous carcinoma with dedifferentiation associated with.
Herein, a case of 55yearold woman who presented with a polypoid lesion at her tongue has been reported. Spindle cells are of mesenchymal origin, and form the bodys connective tissue, fat, muscle, bone, cartilage and blood vessels. 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. Thus, diagnostic markers can be used for the confirmatory diagnosis of various tumors. Surgery was performed and pathologic examination revealed a spindle cell carcinoma. Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm. Hansel et al, spindle cell lesions of the prostate, modern pathology 2007 20, 148158 hansel et al, sarcomatoid carcinoma of the prostate.
Of these, 92 cases were diagnosed and managed in the hospital while 11. Pashaei and colleagues describe a case of superficial leiomyosarcoma and discuss the differentiating histologic and immunohistologic features to distinguish the entity from other histologically similar cutaneous spindled neoplasms, such as atypical fibroxanthoma, spindle cell melanoma, and spindle cell squamous carcinoma. The surgeon did not tell me over the phone whether it is benign. Spindle cell carcinoma and other atypical spindle cell lesions of the head and. This relationship between spindle cell and pleomorphic lipoma, suggested by their clinicopathologic features, have been debated by. Spindle cell lesions of the head and neck are quite diverse with great. Cutaneous spindle cell neoplasms archives of pathology. A spindle cell is a fusiform cell that is tapered at both ends. These tumors constituted 70% of all spindle cell tumors recorded fig. Combining the results of five major related studies 17. Sarcomatoid spindle cell carcinoma of the head and neck. 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. Spindle cell lesions of head and neck include a diverse group of clinically and.
A study of 42 cases, american journal of surgical pathology, 2006. For biopsies from the head and neck assessment is further complicated by the range of tissues present at this site, and. They include reactive lesions and benign and malignant neoplasms, which can be cellular or accumulate variable amounts of myxoid or collagenous stroma. It has been reported that the larynx, oral cavity, and pharynx are the sites of predilection of this cancer in the head and neck. A taper gradually decreases toward one end of the crosssection or width image. Spindle cell lesionsneoplastic or nonneoplastic spindle cell.
A number of entities arising in the head and neck region can fall into this category, but the most common are. In the head and neck, the most frequent site is bone, followed by buccal mucosa and tongue 4. They generally are found in middleaged or older animals, most frequently on the proximal and distal extremities, head, neck, and areas prone to trauma. One challenging feature of head and neck pathology is that a dizzying array of spindle cell lesions occur here ranging all the way from reactive to malignant and very aggressive. Tumors of the skin in dogs merck veterinary manual. A retrospective study from 2006 to 2012, of 7500 cases of scc of head and neck region at dr.
Pdf primary spindle cell lesions of the thyroid gland an. These tumors have now been proved to be monoclonal, evolving from conventional squamous carcinoma. Spindle cell hemangioma hemangioendothelioma of the head and neck. The classic spindle cell lipoma is composed of bland spindled cells intermixed with mature adipose tissue figure 1. Mar 16, 2020 webpathology is a free educational resource with 10304 high quality pathology images of benign and malignant neoplasms and related entities. Myofibrosarcomas are spindle cell neoplasms that occur in children or adults in the head and neck, trunk, and extremities as infiltrative neoplasms and that. Originally presented on february 09, 2015 in park city, utah. The variable presentations of anaplastic spindle cell squamous carcinoma associated with tall cell variant of papillary thyroid carcinoma pallavi p.
Spindle cell lesions of thespindle cell lesions of the. Jan 15, 2019 spindle cell squamous cell carcinoma of skin may appear as skin lesions, commonly on sunexposed areas, mostly the head and neck region. According jordan and regezi 5, the prevalence of solitary myofibroma in the oral cavity is very low. Oral surgery, oral medicine, oral pathology, oral radiology and endodontology, 105 2, 216221. Basal cell tumors are common in dogs and most are benign. The term spindle cell lesion, or tumor, is a purely descriptive one and if applied without further qualification is meaningless as a guide to therapy and prognosis. Tumors of the skin in dogs dog owners merck veterinary manual. We provide an overview of the lesions with a spindle cell morphology that may be encountered in this region and detail a.
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