Nspindle cell lesions of head and neck pdf files

Spcc is extremely rare in the head and neck region, especially in the paranasal sinuses. This study evaluates their clinicopathologic characteristics in head and neck mucosal sites and the problems in distinguishing them from other spindle cell tumors. Sarcomatoid spindle cell carcinoma of the head and neck. According jordan and regezi 5, the prevalence of solitary myofibroma in the oral cavity is very low.

The mass was elastic firm, mobile, bluish in color, and well demarcated in magnetic resonance imaging. 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 material which may be available for study. Myxoid changes have been reported in sfts, particularly in the spinal cord lesions, but pure myxoid variants are extremely rare 3. Often neck pain can extend upward into the head, causing frequent headaches for the patient. The histological diagnosis of spindle cell lesions can be challenging in any site, but in this region is particularly so, due to the variety of structures from which they can arise. Some are malignant while many others are benign or simply reactive in nature. Spindle cell lipoma scl is an uncommon benign lipomatous tumor, most commonly occurring in the posterior neck and shoulder. Surgical pathology of the head and neck, third edition 3 vol. Spindle cell carcinomas of the head and neck rarely harbor. Spindle cell lesions of the breast university of utah. The diagnosis of lesions with spindle cell morphology is often difficult. We report two cases of spindle cell carcinoma spcc, one of the maxillary sinus and another of the larynx.

The cells which make up a spindle cell sarcoma are long and narrow, which is known as a spindlecell shape1. Spindle cell sarcomatoid carcinomas of the larynx lester dr. This is especially noticeable when the patient looks down at a computer screen or spends time looking at his or her cell phone. The histogenesis of these tumors is controversial, as is the prognosis for patients with spindle cell carcinoma of the head and neck when compared with all squamous cell carcinomas of these sites. Pdf spindle cell hemangioma hemangioendothelioma of the. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Ct n 5 and mr n 3 images of seven patients five men and two women. The tumors generally begin in layers of connective tissue such as that under the skin, between muscles, and surrounding organs, and will generally start as a small lump with inflammation that grows. Jul 18, 2012 spindle cell tumours can be benign suffix oma or malignant suffix sarcoma, and will arise from these different cell lines. A spindle cell is a fusiform cell that is tapered at both ends.

It is sometimes classified as a sarcomatoid carcinoma of the lung. Spindle cell lipomas have a wide variety of appearances. May 28, 2008 spindle cell lesions of the head and neck are quite diverse with great clinical and biological heterogeneity. Spindle cell carcinoma spcc, also known as sarcomatoid carcinoma or pseudosarcoma, of head and neck is a rare neoplasm. Spindle cell sarcoma is a type of connective tissue cancer in which the cells are spindle shaped when examined under a microscope. Pdf sarcomatoid spindle cell carcinoma of the head and neck. These findings can have significant implications with regard to not only dental disease, but also diseases of the sinuses, jaw, and surrounding soft tissues. Dental anatomy and pathology encountered on routine ct of the. Providing an interdisciplinary approach to the diagnosis, treatment, and management of head and neck diseases, this source promotes clear communication between pathologists and surgeons. Spindle cells, hyalinized collagen bundles and adipocytes can have cellular pleomorphism based on the ratio of components and pleomorphism, subclassified as classic, collagenized, epithelioid, cellular, lipomatous and variants resembling solitary fibrous tumor. Mostafa differential diagnosis of lesions in the floor of the mouth 2.

Although both luminal epithelial and myoepithelial cells may assume spindle shapes, spindle cell lesions of the breast usually refer to conditions that are composed of mesenchymal or mesenchymallike cells that harbour elongated and stretched cytoplasm. Immunohistochemistry along with routine histopathology is essential in establishing the diag. Spindle cell definition is a fusiform cell as in some tumors. Br premalatha et al clear cell tumors of the head and neck. Clear cells, clear cell tumors, mechanism of clearing, physiological clear cells. The files of the university of california san francisco oral pathology biopsy service were systematically searched for all nonodontogenic soft tissue benign and malignant spindle cell neoplasms accessioned during a 20year period encompassing 1982 through 2002. We present a case of sch in the upper lip of a 41yearold woman. Photomicrograph showing sarcoma like spindle shaped tumor cells with. Spindle cell carcinoma is a rare malignant tumor which is generally considered to be a variant of squamous cell carcinoma. Spindle cell carcinoma of the head and neck region. The manual of head and neck imaging is sized to allow residents to read it completely within a matter of days, and it will also serve as an ideal quick reference guide as different clinical situations arise.

Neck pain can extend downward into the shoulders and in the upper part of the back. Pdf spindle cell carcinoma of head and neck, a subtype of squamous cell. Originally presented on february 09, 2015 in park city, utah. It has a more aggressive behavior as compared to classical squomous cell carcinoma warranting surgical interventions with wider surgical margins. Pdf sarcomatoid spindle cell carcinoma of the head and. The purpose of this study was to investigate the ct and mr imaging features of scl in the head and neck. One challenging feature of head and neck pathology is that a dizzying array of spindle cell lesions occur here ranging all the way from reactive. Spindle cell sarcoma treatment what are the options. They are usually well circumscribed and based in subcutaneous tissue but purely dermal tumours also occur. It has been reported that the larynx, oral cavity, and pharynx are the sites of predilection of this cancer in the head and neck. Pathology outlines benign stromal spindle cell tumors bssct.

Spindle cell hemangioma sch, also known as spindle cell hemangioendothelioma, is a unique vascular tumor with combined microscopic features of both a cavernous hemangioma and kaposi sarcoma. Spindle cell carcinoma of the lung a very rare primary pulmonary malignancy. The head and neck is an embryologically and anatomically complex area, with a number of important structures and organs lying in close proximity to one another. Spindle cell definition of spindle cell by medical dictionary. Pdf sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. Epidermal growth factor receptor egfr is expressed by 90 % of conventional scc, and high level expression is associated with a poorer prognosis. Sarcomatoid spindle cell carcinomas of the head and neck are unusual variants of squamous carcinoma commonly reported in the larynx but also described in other mucosal sites such as gingiva, tongue, hypopharynx and nasal cavity 117. 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. A total of 86,162 cases were accessioned in that 20year period. 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. A case of spindle cell carcinoma of the tongue occurring in a 50yearold.

Surgical pathology of the head and neck, third edition is a complete standalone reference covering all aspects of head and neck pathology. Spindle cell carcinoma of lung radiology reference article. Spindle cell sarcoma of the bone bone cancer research trust. Recent examples on the web the 3yearold was diagnosed with a very rare, soft tissue cancer, called spindle cell rhabdomyosarcoma, in july.

These masses typically arise in males aged 4070 years and originate most frequently in the subcutaneous tissue of the upper back, posterior neck, and shoulders. Spindle cell hemangioma sch is a unique benign vascular lesion. Spindle cell lipoma typically occurs in the posterior neck, shoulder and back, and less commonly in a wide range of other locations. The differential diagnosis of imt comprises low grade myofibroblastic sarcomas as well as a long list of benign, reactive, or neoplastic spindle cell lesions, such as leiomyoma, solitary fibrous tumor, spindle cell carcinoma, nodular fasciitis, peripheral nerve sheath tumor, and sex cord stromal tumors.

If the cancer has reached to its upper stage it becomes quite tough for the physician. Spindle cell sarcoma treatment can be done in a better way if it is detected in the first stage. Lesions that can resemble spindle cell sarcomas include ancient schwannoma, nodular fasciitis, and postoperative spindle cell nodules. Some head and neck squamous cell carcinoma variants can be human papillomavirus hpvrelated and have improved outcomes. 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. The lesions may ulcerate and cause scarring of skin the treatment of choice is a surgical excision with clear margins followed by radiation therapy or chemotherapy, as decided by the healthcare provider. It can be difficult to differentiate between the different forms of spindle cell tumours, and also to distinguish between spindle cell neoplasia and a fibroplastic spindle cell proliferative response. Spindle cell hemangioma in the mucosa of the upper lip. Spindle cell carcinoma is thought of as a malignant epithelial tumor with spindle cell morphology. Close cooperation with the ororhinolaryngologist is as mandatory here as with the neurosurgeons in lesions of the brain and spine. Spindle cell carcinoma of head and neck, a subtype of squamous cell carcinoma is a unique and rare neoplasm.

The entities, both benign and malignant, that compose the spindle cell lesions of the breast will be discussed. Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. Spcc is known as a high malignant variant of squamous cell carcinoma, which is composed of conventional squamous cell carcinoma component, either insitu and or invasive and malignant spindle component with sarcomatous appearance. Immunohistochemically, the tumor cells and giant cells are positive for vimentin. Cutaneous spindle cell lesions encompass a heterogeneous group of tumors that range from reactive to benign, borderline, and malignant tumors. Cytological features and differential diagnoses of spindle cell sarcomas. We will not attempt to classify all the lesions in the head and neck regions, but will discuss some of the important aspects of the lesions while presenting the cases. Request pdf spindle cell lesions of the head and neck. In the head and neck, the most frequent site is bone, followed by buccal mucosa and tongue 4. Spindle cell squamous cell carcinoma of skin dovemed. Perivascular and vascular neoplasms of the head and neck are a rare. Spindle cell carcinoma is an unusual variant of squamous cell carcinoma. Spindle cell carcinomas spcc of the head and neck are a rare variant of the squamous cell carcinoma scc, representing less than 3% of all. 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.

In the early stages surgery is the best route, but when the cancer has reached to its upper stage, only chemotherapy is the option. Epidermal growth factor receptor expression in spindle. Some authors also use the term synonymously with pleomorphic carcinomas of the lung, while the who 1999 classification system places the latter as a separate entity. Spindle cell lesions of head and neck include a diverse group of clinically and biologically heterogeneous lesions. 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. Spindle cell definition of spindle cell by merriamwebster.

Solitary fibrous tumor of the spinal cord radiology. Content cystic conditions inflammatory processes vascular lesions neoplastic lesions 3. Lineage mesenchymal, epithelial, lymphoproliferative. Jan 15, 2019 spindle cell squamous cell carcinoma of skin may appear as skin lesions, commonly on sunexposed areas, mostly the head and neck region. 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.

Tumor cells stain positive for the stem cell marker cd34. May 01, 2017 postoperative spindle cell nodules pscns are benign, localized, reactive lesions usually described as histologically identical to inflammatory myofibroblastic tumors imts, except that a history of instrumentation or trauma to the bladder eg, core needle biopsy, surgery can be elicited see the image below. Spindle cell sarcoma is a form of sarcoma that is referred to this way due to the appearance of its tumour cells when they are looked at under a microscope. Spindle cell lipomas scl are relatively rare, slow growing, benign lipomatous tumors. The approach used for the diagnosis of these tumors should be based on knowledge of the relative frequencies of different tumor types, appropriate consideration of clinical context, and correct. Two cases of spindle cell carcinoma of the head and neck. The mass developed 5 years earlier and enlarged after repeated ethanol injections. For biopsies from the head and neck assessment is further complicated by the range of tissues present at this site, and. Spindle cell carcinoma spcc is an uncommon head and neck squamous cell carcinoma scc variant consisting of spindled andor pleomorphic cells with epithelial differentiation.