A case of radiation-induced spindle cell sarcoma of tongue

Abstract

Objectives: Sarcoma arising from tongue is rare. We have experienced a case of sarcoma possibly induced by previous radiation to the oral cavity. The clinical course and the management of this tumor is presented Methods: A 70-year-old male received chemoradiotherapy to his mesopharyngeal cancer (T3N1M0) in December 2000. The patient was well until July 2003 when he has had a rapidly growing mass lesion arising from the right edge of tongue. A couple of biopsies were done and the pathology showed granulation without malignancy. Because of the further rapidly growing tumor mass in October 2003, a radical excision of the tumor was done. Results: A 7 × 4 × 5.5 cm grayish elastic hard tumor was removed from his oral cavity. The tumor invaded deeply into the tongue and hence the right one third of the tongue was excised along with the tumor. Histopathologically, the tumor showed interwoven spindle-shaped cells with marked atypia. Part of the spindle cells infiltrated into the tongue tissues. Immunohistochemical stains showed AE1(-), CAM5.2(-), Vimentin(+), f ¿-SMA(+). Radiation-induced spindle cell sarcoma was most suspected. Conclusion: We have experienced a case of spindle cell sarcoma possible induced by the previous radiation. Radical excision is crucial in the treatment of this tumor.