English

Abstract

Spindle cell carcinoma is a rare variant of squamous cell carcinoma. The most frequently affected site is larynx, however, it may infrequently occur in various organs; gingiva, tongue, upper aerodigestive tract including hypopharynx and nasal cavity, esophagus, skin and breast. Here is a case who presented in department of ENT with nasal complaints and was diagnosed with spindle cell carcinoma. Spindle cell carcinoma (SpCC) is a rare, high malignant variant of squamous cell carcinoma (SCC), which shows biphasic proliferation of conventional SCC component and malignant spindle shape cells with sarcomatous appearance. INTRODUCTION:: Spindle cell carcinoma (SpCC), also known as sarcomatoid carcinoma, is a rare malignancy of the head and neck regions. It is most frequently encountered in the larynx, and also occurs in the nasal cavity, hypopharynx, oral cavity, esophagus, trachea, skin and breast. In a previous series of laryngeal malignancy, about 1% were diagnosed with SpCC.1 Male predominance was also noted. SpCC is an unusual form of poorly differentiated squamous cell carcinoma (SCC) consisting of elongated (spindle) epithelial cells that resemble a sarcoma. Many of these tumors may be easily confused with true sarcomas unless special immunohistologic or ultrastructural analysis is performed. Such analyses show concurrent presence of malignant epithelial and homologous sarcomatoid spindle cell components by co-expression of cytokeratin, epithelial membrane antigen, and vimentin to various degrees.2,3 The spindle cell components have been considered to be either a variant growth pattern of SCC, a non-neoplastic mesenchymal reaction, or a malignant admixture of epithelial and mesenchymal neoplasms.4 However, the majority of the spindle cell components are non-diploid, which indicates that they are neoplastic and not reactive.5 The vimentin positivity reflects that these bizarre fibroblast-like cells are carcinoma cells with true mesenchymal metaplasia. Electron microscopy often shows the presence of junctional complexes between tumor cells, with or without pericellular basal lamina and cytoplasmic skeins of intermediate filaments.6 CASE REPORT: A 35 year old male pt presented to ENT OPD with history of bleeding from right nasal cavity for 2 years and nasal obstruction in right nasal cavity for 1 year . Both the history was of insidious onset and progressive in nature. Patient was advised to undergo a biopsy from the right nasal cavity and biopsy was taken from the mass in the right nasal cavity 15 days back. Following this patient was referred to our hospital for further management. There is no significant past history and family history. General physical examination was within normal limits. Local examination.