Case Of Spindle Cell Carcinoma Research Articles

Clinical analysis of 95 cases of pulmonary sarcomatoid carcinoma.

To collect data on the clinical characteristics, pathologic presentation, and prognosis of patients with pulmonary sarcomatoid carcinoma. From September 24, 2008 to June 3, 2014, 95 patients were hospitalized at the Shanghai Chest Hospital for the treatment of pulmonary sarcomatoid carcinoma. We retrospectively collected patient gender, age, smoking history, time of initial diagnosis, diagnostic methods, tumor location, pathohistological subtype, tumor size, TNM stage, immunohistochemical results, subsequent treatments, and patient survival. Of the 95 patients included in this study, 80 were male and 15 were female. Median patient age was 64 years (range: 43-80 years). There were 29 cases of pleomorphic carcinoma, one case of giant cell carcinoma, six cases of spindle cell carcinoma, and six cases of carcinosarcoma. The other 53 cases were not subtyped. The median survival was 11.54 months (range: 0.9-100.9 months). 1-, 2-, 3-, and 5-year survival was 32%, 30%, 25%, and 21%, respectively. Univariate analysis showed that tumor size, stage, T1+T2 vs T3+T4 stage, N stage, and M stage were prognostic factors for survival. Multivariate regression analysis showed that T stage and lymph node metastases were independent prognostic factors. Pulmonary sarcomatoid carcinoma is an uncommon, aggressive cancer. T1+T2 vs T3+T4 stage and lymph node metastases were independent prognostic factors. Our results underscore the importance of early detection and early diagnosis. Effective treatments for this disease are lacking.

Wide expression of ZEB1 in sarcomatous component of spindle cell carcinoma of the esophagus.

The pathogenesis of sarcomatous component in spindle cell carcinoma (SpCC) of the esophagus is unclear. To investigate the involvement of epithelial-mesenchymal transition (EMT) in sarcomatous differentiation, we performed immunohistochemistry for Slug, Twist, ZEB1, and ZEB2, transcription factors associated with EMT and E-cadherin, in 14 cases of SpCC of the esophagus. In order to verify the neoplastic nature of sarcomatous components, TP53 mutation status and protein expression were examined in each case. Nuclear ZEB1 expression was extensive in the sarcomatous component, greater than invasive front of carcinoma components (P < 0.0001). Membranous E-cadherin expression was mostly lost in sarcomatous cells in all cases (P < 0.0001). The p53 expression pattern was almost concordant between the two areas in all cases. TP53 mutation analysis revealed that seven cases harbored identical mutations in both components. One case had mutations only in the sarcomatous component. It is noteworthy that none of them harbored mutation in exon 5, unlike conventional esophageal squamous cell carcinoma. These findings show that ZEB1 are widely expressed in the sarcomatous area of SpCC of the esophagus, suggesting the involvement of EMT. The avoidance of exon 5 in terms of TP53 mutation may also be a feature of the tumor.

Epidermal Growth Factor Receptor Expression in Spindle Cell Carcinomas of the Head and Neck.

Spindle cell carcinoma (SpCC) is an uncommon head and neck squamous cell carcinoma (SCC) variant consisting of spindled and/or pleomorphic cells with epithelial differentiation. Epidermal growth factor receptor (EGFR) is expressed by >90 % of conventional SCC, and high level expression is associated with a poorer prognosis. Anti-EGFR therapies are commonly used to treat head and neck SCC. However, no studies have evaluated EGFR expression in SpCC. Cases of SpCC were retrieved from department files. The diagnosis required either a biphasic lesion with a squamous neoplastic component, or a purely spindle cell or pleomorphic tumor with immunohistochemical positivity for epithelial markers. EGFR immunohistochemistry was performed and was quantified in quartiles. Medical records were reviewed for clinical follow up information. EGFR was expressed in 21/30 (70 %) cases, including in the squamous component in 18/19 (95 %) and the spindle cell component in only 12/30 (40 %). Where the spindle cell component was positive, the intensity and distribution were lower than for the squamous component. Recurrent tumors were predominantly (80-90 %) of the spindle cell component, and had low (or absent) EGFR expression. Kaplan-Meier survival analysis showed no statistically significant differences in overall or disease free survival between the EGFR expressing and non-expressing groups (p = 0.414 and 0.19, respectively). SpCCs of the head and neck have a poor prognosis, and markedly reduced EGFR expression. EGFR-specific therapies may not be ideal for SpCC patients, which may lack EGFR expression, but further studies are needed.

T3肺癌術後放射線照射13年後に発生した紡錘細胞癌の1例

T3肺癌術後放射線照射13年後に発生した紡錘細胞癌の1例

Two Cases of Spindle Cell Carcinoma of the Head and Neck

Two Cases of Spindle Cell Carcinoma of the Head and Neck

頭頸部紡錘細胞癌2例

頭頸部紡錘細胞癌2例

下咽頭紡錘細胞癌例

下咽頭紡錘細胞癌例

急速に進行した乳腺紡錘細胞癌の１例

急速に進行した乳腺紡錘細胞癌の１例

化学療法抵抗性で急速な転帰をとった乳腺原発紡錘細胞癌の1例

化学療法抵抗性で急速な転帰をとった乳腺原発紡錘細胞癌の1例

Spindle cell carcinoma of the larynx: A rare case report

Spindle cell carcinoma (SpCC) of the larynx, a subtype and a more aggressive variant of the commonly occurring squamous cell carcinoma, is a unique and rare neoplasm. It comprises of 0.6–1.5% of all laryngeal cancers. Macroscopically, it usually presents as a large pedunculated, polypoidal mass with surface ulceration. Microscopically, however, it is considered as a biphasic tumor that has surface epithelial changes (in situ to invasive carcinoma) and an underlying mesenchymal spindle shaped neoplastic proliferation. If detected early, it has a very good prognosis. We present a case of SpCC in a 70-year-old male, who presented with progressive hoarseness since 1 year. The mass was removed under videolaryngoscopic guidance and thereafter, the patient underwent cobalt 60 radiotherapy. His symptoms gradually improved, and he regained good control of his voice.

多発頸部再発に対して放射線照射およびS-1 投与が著効した舌紡錘細胞癌の1例

Spindle cell carcinoma (SpCC) is a subtype of squamous cell carcinoma (SCC) and has a poor prognosis. We report a case of SpCC of the tongue with multiple ipsilateral neck recurrence and contralateral lymph node metastasis successfully treated by radiotherapy followed by S-1 administration. A 72-year-old woman consulted our center in August 2010 because of a mass in the right margin of the tongue. The mass was an exophytic granulomatous tumor measuring 25×20×17mm. She had received a partial glossectomy for SCC (T1N0M0) of the right side of the tongue in 1999. Based on the clinical diagnosis of recurrence of SCC (rT2N0M0), a partial glossectomy was done in October 2010. Histopathological examinations revealed SpCC. One month after surgery, radical neck dissection was done for ipsilateral metastasis. Three months after the second procedure, she had multiple ipsilateral neck recurrence involving the retropharyngeal lymph nodes, with contralateral lymph-node metastasis. Because radical surgery was considered extremely difficult, the patient underwent palliative radiotherapy (total 36 Gy). After the radiotherapy, S-1 was administered. After 1 course of treatment, the lesion of the cervical region markedly shrank. Currently, she has been receiving S-1 and remains free of disease as of 44 months after surgery.

Very Rare Case of Spindle Cell Carcinoma of Breast in Male

Metaplastic breast carcinoma is uncommon, constitutes ≤ 5% of all breast cancers, and is classified into various subtypes with varying incidences. Of these subtypes, spindle cell carcinoma represents approximately 0.3% of all invasive breast carcinomas in women. The spindle cell carcinoma subtype of metaplastic breast carcinoma is typically triple negative and has distinct clinical, radiological, and pathological characteristics. To date, there is no effective treatment for this malignancy. Herein, we report a case of spindle cell carcinoma of the breast in a 71 year-old man who presented with a palpable mass in his left breast. Breast ultrasonography revealed a 1.1 × 2.6 cm hypoechoic welldemarcated ovoid mass. The patient underwent excisional biopsy. Pathological findings indicated a diagnosis of spindle cell carcinoma of the breast, and the patient underwent a modified radical mastectomy. The final pathological report indicated a 6.5× 3.0 cm malignant spindle cell tumor.

A case of spindle cell carcinoma on the floor of the mouth

Spindle cell carcinoma is characterized by the proliferation of polygonal cells, comprising mainly tumor cells, and is classified as a type of squamous cell carcinoma. The frequency of spindle cell carcinoma in the oral cavity is low, particularly on the floor of the mouth. We report a patient presenting with a spindle cell carcinoma on the floor of the mouth.

Clinicopathological and immunohistochemical analysis of spindle cell carcinoma of the larynx or hypopharynx: A report of three cases.

Spindle cell carcinoma (SpCC) is a rare and unusual biphasic malignant tumor, which involves sarcomatoid proliferation of pleomorphic spindle cells and squamous cell carcinoma. There are various reports on the clinical and pathological findings of SpCC in the head and neck; however, this type of tumor remains uncommon in the larynx and hypopharynx. The histogenesis of SpCC has been the subject of debate for many decades. Although it is generally accepted that SpCC is a monoclonal epithelial neoplasm, and the spindle cell element is derived from squamous epithelium with divergent mesenchymal differentiation, this type of tumor poses a significant diagnostic challenge to pathologists and clinicians with regard to the therapeutic approach. In the present report, three cases of SpCC of the larynx or hypopharynx were investigated. The histological and immunohistochemistry findings are presented to provide further data on this rare type of tumor.

超音波にて嚢胞内腫瘍として描出された乳腺紡錘細胞癌の1例

症例は66歳，女性．当院併設の検診センターでの乳癌検診にて触診およびマンモグラフィで腫瘤を指摘され当科初診．触診にて右乳房A領域に径25mm大の腫瘤を触知．マンモグラフィでは右M-Iに径20mm大の境界不明瞭腫瘤を認め，カテゴリー4の診断．超音波では右A領域に内部に充実性成分を伴う嚢胞内腫瘍を認めた．超音波ガイド下針生検施行し，化生癌，ER0％，PgR0％，HER2（-）と診断された．遠隔転移・腋窩リンパ節転移を疑う所見なく，左乳房切除およびセンチネルリンパ節生検術を施行した．病理組織学的に乳腺紡錘細胞癌と診断された．超音波にて嚢胞内腫瘍として描出された乳腺紡錘細胞癌の1例を経験したので報告する．

乳腺紡錘細胞癌の２例

乳腺紡錘細胞癌の２例

Spindle Cell Carcinoma of the Larynx Presenting as a Vocal Fold Cyst

Spindle cell carcinoma (SPCC) is a rare, malignant variant of squamous cell carcinoma (SCC), which shows biphasic proliferation of the conventional SCC component and malignant spindle shape cells with sarcomatous appearance. We present two cases of SPCC of the true vocal fold that presented as a benign appearing subepithelial mass. We discuss the patient presentation, voice assessment, surgical treatment, and a review of the literature.

A case of spindle cell carcinoma in the floor of the mouth

A case of spindle cell carcinoma in the floor of the mouth

Spindle cell carcinoma of the nasal cavity

Spindle cell carcinoma (SpCC) is a unique variant of squamous cell carcinoma (SCC). SpCC confined to the nasal cavity is extremely rare, with only one case having been previously reported. We present a case report of nasal cavity SpCC and review the literature on this rare entity. A 29-year-old male presented with intermittent epistaxis from the left nasal cavity. On physical examination, the patient had an ulcerated mass in the left nasal vestibule and a biopsy showed a proliferation of spindle and epitheliod cells. The patient underwent wide local excision of the mass via a lateral alotomy approach and reconstruction with a composite conchal bowl skin and cartilage graft. Histologically, the mass had dyplastic squamous epithelium and spindle-shaped cells admixed with epitheliod cells. Immunohistochemistry was only positive for pancytokeratin AE1/AE3 and vimentin. Six months after surgery, the patient continues to have no evidence of disease. On literature review, only one previous case of SpCC confined to the nasal cavity was identified. We present a rare case of nasal cavity SpCC. No definite treatment protocol exists for this unique entity, but we believe that this tumor should primarily be treated with aggressive, wide local excision. Adjuvant radiation and/or chemotherapy have also been used anecdotally.

Spindle Cell Carcinomas of the Head and Neck Rarely Harbor Transcriptionally-Active Human Papillomavirus

Spindle cell carcinoma is an uncommon variant of squamous cell carcinoma characterized by spindled or pleomorphic cells which appear to be a true sarcoma but are actually epithelial. Some head and neck squamous cell carcinoma variants can be human papillomavirus (HPV)-related and have improved outcomes. We sought to determine if spindle cell carcinomas are associated with transcriptionally-active HPV. Cases of spindle cell carcinoma were retrieved from department files. Transcriptionally-active HPV was determined by mRNA in situ hybridization for high risk HPV E6 and E7 transcripts and by a surrogate marker, p16 immunohistochemistry, with a 50% staining cutoff. RT-PCR for high risk HPV mRNA was performed on the cases that were technical failures by in situ hybridization. Medical records and follow up information were retrieved for all patients. Of 31 cases, 5 were from the oropharynx, 12 from the oral cavity, and 14 from the larynx or hypopharynx. One purely spindled oral cavity spindle cell carcinoma was HPV positive. It was also diffusely positive for p16. Another laryngeal spindle cell carcinoma was HPV positive in both the squamous and spindle cell components, but was negative for p16. None of the five oropharyngeal spindle cell carcinomas were positive for p16 or HPV RNA. The HPV positive patients both presented at high stage (IV) and died with disease within 2 years of diagnosis. The majority of spindle cell carcinomas of the head and neck, including those arising in the oropharynx, are not related to transcriptionally active HPV. Although the number of cases is too small for any definitive conclusions, for the rare HPV positive spindle cell carcinoma cases, positive viral status does not appear to confer any prognostic benefit.