Abstract

There have been few reports on cases of spindle cell squamous cell carcinoma of the oral cavity. In this paper, we report a case of spindle cell squamous carcinoma arising in the tongue. A 76-year-old male with tongue squamous cell carcinoma was referred to our hospital. After two courses of neoadjuvant chemotherapy, subtotal resection of the tongue, unilateral radical neck dissection, and reconstruction with free transverse rectus abdominis myocutaneous flap were performed. Pathological diagnosis of the surgical specimen was spindle cell squamous carcinoma (pT3N0M0, Stage Ⅲ). Recurrence of primary tumor was detected about four months after the operation and it showed extremely rapid growth. Palliative radiotherapy (two courses with 24Gy/8 fractions and 20Gy/5fractions) effectively controlled the patient’s quality of life. It is thought that although spindle cell squamous carcinoma clinically shows a response to radiotherapy or chemotherapy, some tumor cells (low sensitivity cancer stem cells) may resist and survive. So, radical resection with wider surgical free margin may be essential.

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