Pulmonary metastasis deposits on the ct image of patient 2 at a day 0 initial examination and b 39 days after. Spindle cell hemangioma is an uncommon benign vascular tumor of the oral cavity. A tumor, by definition, is simply a swelling of thea tumor, by definition, is simply a swelling of the tissue. Knowledge of the complex anatomy of the oral cavity and oropharynx, as well as the most common routes by which scc spreads from vari. Only the cells lining the vascular spaces and the epithelioid cells stain for endothelial markers cd31 and cd34. When local oral disease is present it may have a direct impact on the systemic health of the individual. 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. Originally presented on february 09, 2015 in park city, utah. Metastatic tumours in the oral cavity are very uncommon and represent approximately 1% of all the cases of neoplasms in the oral cavity. It starts with an overview of the relevant anatomy of the floor of the mouth, the tongue, the lips and gingivobuccal regions, the hard palate,and the region of the retromolar trigone. Spindle cell carcinoma represents a rare variant of squamous cell carcinoma, characterized by spindled tumor cells that simulate a sarcoma but are epithelial in nature. Sarcomatoid carcinoma sc is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes. A case report ezulia t 1, saim l 2, primuharsa putra sha 2 and ms kenali 2 1 department of otorhinolarygology, school of medicine, kpj healthcare. Consultant, department of dental services, asian institute of.
Spindle cell squamous carcinoma of the oral region. Spindle cell lesions of the breast university of utah. A total of 35 mucosal granular cell tumors, 4 granular cell ameloblastomas, 1 lichen planus with granular cell change, and 3 congenital epulides of the newborn were studied. The most common malignant spindle cell tumor was ks, but other malignancies were rare. The mass developed 5 years earlier and enlarged after repeated ethanol injections. Spindle cell lipoma of the mandibular mucogingival. 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 appearance. Not all the spindle cell tumors in oral cavity are.
Spindle cell squamous cell carcinoma spcc is a poorly differentiated subtype of squamous cell carcinoma sqcc. Surgery was performed and pathologic examination revealed a spindle cell carcinoma. Immunohistochemical differentiation between spindle cell lipoma and neurofibroma of oral cavity. In the oral cavity, myofibroma occurs within the submucosal or intramuscular tissue and has a predilection by the tongue, buccal mucosa and lips. The diagnosis often represents a clinicalpathological. Oral lesions that appear as multiple, painless, grayish white plaques covering ulcerated mucosa these lesions are the most infectious.
Presentation in the oral cavity is rare with only two previously reported cases. Aug 09, 2017 spindle cell lesions of oral cavity part i 1. Spindle cell lipoma scl is a variant of lipoma, usually presenting in the neck or trunk. They undergo spontaneous remission but may recur for months or years. June 2017 includes ptnm requirements from the 8th edition, ajcc staging manual. Spindle cell is a histomorphologic descriptor used in pathology. One of the changes often found in dna of oral cancer cells is a mutation of the tp53 gene. Case report spindle cell myoepithelial carcinoma of the oral cavity a report of two cases shubhada v. Ernest borges road, parel, mumbai400017, maharashtra, india b department of surgery, tata memorial hospital, parel. Molecular characterization of clear cell lesions of head and neck. Rizzardi c, frezzini c, maglione m, tirelli g, melato m.
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. Oral cavity at thomas jefferson university studyblue. The aim of the case report is to present the histopathologic features of a scl. A simple working type classification is proposed here for spindle cell neoplasms of the oral cavity table 1. This classification is based on the predominance of spindle cells in the histopathology of the lesions of the oral cavity.
A spindle cell carcinoma presenting with osseous metaplasia. We describe the largest series yet of oral spindle cell lipoma. A look at the biology of spindle cell squamous carcinoma of the oral cavity. Using diode laser for soft tissue incision of oral cavity reza amid 1, mahdi kadkhodazadeh 1, mohammad reza talebi ardakani 1, somayeh hemmatzadeh 2 soheil refoua 2, parastoo iranparvar 2, anahita shahi 2 1 dental research center, department of periodontics, shahid beheshti university of medical sciences, tehran, iran 2. Spindle cell lesions of thespindle cell lesions of the prostate. The high prevalence of ks in this series is likely reflective of demographics unique to the san francisco bay area. A great deal of research is being done to learn about the dna changes that cause the cells in the oral cavity and oropharynx to become cancer. Using diode laser for soft tissue incision of oral cavity. Electron microscopy often shows the presence of junctional complexes between tumor cells, with or without pericellular basal lamina and cytoplasmic skeins of intermediate filaments.
Molecular characterization of clear cell lesions of head. Pediatric soft tissue oral lesions pocket dentistry. Spindle cell lipoma of the oral cavity ovidinsights. The diagnosis and management of giant cell lesions of the. 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. 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 diagnosis of many lesions of the oral cavity is challenging to most clinicians because of their uncommon prevalence. Cd34, connective tissue tumor, neurofibroma, softtissue tumor, sox10, spindle cell lipoma how to cite this article. Risk factors for spindle cell carcinoma of the upper aerodigestive tract include tobacco use.
Ernest borges road, parel, mumbai400017, maharashtra, india. The spindle cell neoplasms of the oral cavity europe pmc. Spindle cell myoepithelial carcinoma of the oral cavity a. Not all the spindle cell tumors in oral cavity are sarcomatoid squamous cell carcinoma. A case report ezulia t 1, saim l 2, primuharsa putra sha 2 and ms kenali 2 1 department of otorhinolarygology, school. Spindle cell carcinoma arising in maxilla is much rarer occurrence in literature 7 with few cases reported since 1957 table 1. A clinicopathological, immunohistochemical, and ultrastructural study of 44 oral granular cell lesions was performed. Whats new in oral cavity and oropharyngeal cancer research.
We describe the largest series yet of oral spindle cell lipoma involving the tongue 4. The entities, both benign and malignant, that compose the spindle cell lesions of the breast will be discussed. An entity described as myxoid lipoma of the oral cavity has rarely been reported but appears to be more properly classified as spindle cell lipoma. 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. Benign tumors may affect a small area, such as a single tooth. It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. Most spindle cells stain only for vimentin and a smaller percent for actindesmin. The diagnosis of oral mucosal lesions and normal variants of the oral mucosa is very important in successful therapeutic management of a patient with an oral mucosal disease.
The bidirectional relationship between oral health and systemic health cannot be over emphasized. In the head and neck region, the two most important malignancies which can present with this appearance are spindle cell squamous carcinoma and malignant melanoma. Factors affecting outcome hsinghao su1, sautung chu 1, yuyi hou1,2, kuoping chang, chiajung chen3 departments of 1otorhinolaryngology and 3pathology, kaohsiung veterans general hospital, and 2fooyin university hospital, kaohsiung, taiwan, r. The patients were 23 men and 12 women, with a mean age. In the oral cavity, the origin of the spindle cell neoplasms may be traced to. Spindle cell carcinoma an overview sciencedirect topics. Health care providers realized the oral cavity maybe a potential source of implementation or infection due to a variety of reasons. We report a case of spindle cell hemangioma that presented as an asymptomatic mass of the buccal mucosa in a 44. For accreditation purposes, this protocol should be used for the following procedures and tumor types.
Sep 11, 2014 introduction oral medicineprimary and secondary lesions 1. In the majority of cases, the primary tumour is known. In the strict sense,the word does not imply atissue. The patient underwent surgery and adjuvant chemoradiotherapy. Spindle cell myoepithelial carcinoma of the oral cavitya. Department of oral and maxillofacial surgery, kobe university graduate school of medicine. 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. Spindle cell myoepithelial carcinomas of the oral cavity are very rare primary salivary gland tumors and have remained under diagnosed until recently, essentially due to lack of awareness of such an entity and also due to varied immunoreactivity in spindle cell variant. Although more common in other sites in the body, spindle cell neoplasms are rare in the oral cavity, as this study has shown. A look at the biology of spindle cell squamous carcinoma of. Diagnosis of tumors of the gums in cats first, your vet will perform an oral examination, looking carefully for lesions in the oral cavity. 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. We report here a case of spindle cell carcinoma arising from the maxilla in a. Spindle cell lipoma scl is a benign lipomatous neoplasm typically located in the posterior neck and back of older males.
Spindle cell lesions of thespindle cell lesions of the prostate j. The tumor can arise anywhere within the upper aerodigestive tract, with a predilection for the larynx and oral cavity. 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. Oral pathology infectious diseases with manifestations in oral cavity. Spindle cell carcinoma spcc is a relatively rare malignancy affecting the upper aerodigestive tract. 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. Herein, a case of 55yearold woman who presented with a polypoid lesion at her tongue has been reported. Second primary spindle cell carcinoma of oral cavity and. Sarcomatoid carcinoma of the oral cavity comprises less than 1% of all tumors of the oral cavity. A rare case report richa wadhawan 1, nisheeth saawarn 2, swati saawarn 3, dharmendra sharma 4 1 reader, department of oral medicine and radiology, institute of dental education and advance studies, gwalior, madhya. Rare cases of oral spindle cell lipoma have been reported. 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. Spindle cell carcinoma of the oral cavity and oropharynx. Spindle cell carcinoma spcc synonymously called sarcomatoid tumor occurs mainly in the upper aerodigestive tract.
In the oral cavity, the origin of the spindle cell neoplasms may be traced to epithelial, mesenchymal and odontogenic components. The mass was elastic firm, mobile, bluish in color, and well. A simple working type classification proposed for the. Immunohistochemical differentiation between spindle cell. Learn distinctive features of select spindle cell tumors for accurate identification. Oral cavity questions and study guide quizlet flashcards by. Seminar on spindle cell tumors of the oral cavity part i by. Presence of this tumor type in the tongue has rarely been reported. The diagnosis of oral mucosal lesions and normal variants of. Spindle cell lipoma is typically seen in the necktrunk region of middleaged and older men. Oral cavity and oropharyngeal squamous cell cancer. Typically, this lesion is seen in neonates and infants with few cases reported in adults patients. Atypical fibroxanthoma is a pleomorphic spindle cell tumor of the dermis and its been known to be a benign lesion clinically.
Oral mucosal lesions in children may present as ulcers, color changes, alterations in size, and configuration of oral anatomy. Immunohistochemically, the endothelial vascular lining was highly reactive with ham56 antibody, while variable reactivity was observed for factor viii. 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. An entity described as myxoid lipoma of the oral cavity has rarely been reported but appears to be more properly classified as spindle cell. Spindle cell carcinoma of the nasal cavity semantic scholar. Spindle cell hemangioma in the mucosa of the upper lip. Myofibroma is an uncommon spindle cell neoplasm rarely found in oral cavity. 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 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.
Seminar on spindle cell tumors of the oral cavity part iii by. A list of spindle cell lesions is found the in the spindle cell lesions article. We report a case with second primary oropharyngeal spcc after seven years of complete treatment of sqcc. Bagwan a, tanuja shet a, prashant bavi a, anil dcruz b a department of pathology, tata memorial hospital, dr. The primary goal of this course is to help dental professionals learn the process of clinical evaluation, differential diagnosis and. Introduction oral medicineprimary and secondary lesions. Spindle cell hemangioma, formerly termed spindle cell hemangioendothelioma, is an uncommon benign vascular tumor. Pg student, department of oral pathology,sudha rustagi college of dental sciences and research,faridabad, haryana 2. Spcc occurs commonly in 67th decades of life and represents a male predominance. We present a case of sch in the upper lip of a 41yearold woman.
This is the first report of sch in the oral cavity. Spindle cell carcinoma spcc an aggressive squamous cell carcinoma, variant, frequently. Six cases of spindle cell squamous carcinoma scsc of the oral cavity were studied clinicopathologically, immunohistochemically and ultrastructurally to summarize the clinicopathological features of this rare neoplasm and to discuss the debatable histogenesis of the sarcomatoid component and the differential diagnosis of scsc. There is no approved working classification for spindle cell neoplasms of the oral cavity in the literature. The diagnosis of ccceot is very difficult and other clear cell lesions that affect the oral cavity should be excluded. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Spindle cell pleomorphic lipoma is an uncommon benign adipose tissue tumor most frequently arising from the subcutaneous tissue of the back, shoulder, head and neck, and extremities. Seminar on spindle cell tumors of the oral cavity part ii by. Spindle cell lipoma scl, an uncommon histologic variant of lipoma, is a benign tumor that often occurs in the posterior neck or shoulder with rare occurrence in the oral cavity. Definitions oral diagnosis is defined as an art and science of identifying an oral disease from its symptoms and signs. An insight on salient features for oral and maxillofacial pathologists ramakant gupta1, swati gupta2, manju gupta3 1. The most common site of origin in head and neck region is larynx particularly vocal cords and hypopharynx. This chapter deals with benign and malignant neoplasms of the oral cavity.
Spindle cell myoepithelial carcinoma of the oral cavitya report of two cases shubhada v. Spindle cell hemangioma sch is a unique benign vascular lesion. 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. All cell types were positive for vimentin and anti. Lipomatous tumors benign malignant cellular rhabdomyoma spindle cell rhabdomyosarcoma benign malignant leiomyoma angiomyoma leiomyosarcoma benign malignant spindle cell hemangioendothelioma angiosarcoma kaposi sarcoma 4. Protocol for the examination of specimens from patients with cancers of the lip and oral cavity. Spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and mesenchymal components. It presents as a wellcircumscribed mass in the buccal mucosa, tongue. Department of oral pathology and microbiology, tern dental college, nerul, navi mumbai, maharashtra, india abstract spindle cell soft tissue neoplasms are rarely reported in the oral cavity and account for less than 1% of all tumors. These tumour variants demonstrate a rather consistent biphasic histologic pattern with areas diagnostic of the tumour entity in question and other areas with conspicuous clear cell component. Tumors of the gums in cats symptoms, causes, diagnosis. Spindle cell carcinoma spcc, also known as sarcomatoid carcinoma or pseudosarcoma, of head and neck is a rare neoplasm. Mandible, mandibular cystic lesions, mandibular odontogenic solid tumors, toothrelated sclerotic mandibular lesions, nonodontogenic mandibular tumors the mandible is a physiologically complex bone that plays a role in phonation, mastication, and jaw stability.
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