Spindle cell carcinoma is considered to be a biphasic tumor that is composed of a squamous cell carcinoma (in situ or invasive) and spindle cell carcinoma with sarcomatous appearance. Squamous cell carcinoma is the most malignant carcinoma of the larynx, and spindle cell (sarcomatoid) tumor is considered a highly malignant variant of squamous cell carcinoma. Spindle cell (sarcomatoid) carcinoma of the larynx is a rare tumor and comprises 2% to 3% of all laryngeal cancers. His symptoms gradually improved, and he regained good control of his voice. The patient underwent direct laryngoscopy with excision of the malignant mass and received radiation therapy.

We present a case of spindle cell carcinoma in a 67-year-old Caucasian male who presented with progressive hoarseness of his voice, dysphagia, odynophagia and a 20-pound weight loss. Most spindle cell tumors are polypoid and pedunculated they are often detected at an early stage, removed by polypectomy during diagnosis, and tend to have a very good prognosis. It is considered to be a biphasic tumor that is composed of a squamous cell carcinoma (in situ or invasive) and spindle cell carcinoma with sarcomatous appearance. In all cases, a rapid and accurate diagnosis is important for treatment and prognosis.Spindle cell carcinoma (SpCC) or sarcomatoid carcinoma is a highly malignant variant of squamous cell carcinoma which comprises 2% to 3% of all laryngeal cancers. They metastasise rarely (apart from haemangiosarcomas).

Wide surgical excision is the treatment of choice. Sarcomas are often highly infiltrative and locally aggressive, with a high likelihood of recurrence. Spindle cell proliferation occurs as a fibroplastic response in granulomatous inflammation, and this may be impossible to differentiate from benign or malignant neoplasms.Ī biopsy and histopathology are usually necessary to confirm the diagnosis.īenign forms are usually well circumscribed and can be surgically removed with an excellent prognosis. Large, plump spindle cells large nuclei and prominent nucleoli prominent nuclear variability multinucleated giant cells pink extracellular stroma Often, a diagnosis of spindle cell tumour is as specific a diagnosis as can be made.Ĭommon cytological findings for benign spindle cell tumours include: small spindle-shaped cells, small nuclei, minimal anisocytosis.Ĭyological findings for sarcomas include: It may be possible to determine the tissue of origin if there is evidence of collagen, cartilage, bone, fat or myxomatous material formation by the tumour cells. Nuclei are often fusiform as well and cytoplasmic tails may fade into the background. On cytological examination: cells are individual rather than adherent, fusiform, and with indistinct cell borders. Generally spindle cell tumours do not exfoliate well, although exceptions exist. Other tumours Haemangiopericytoma and Schwannoma Diagnosis Tumours of the lymphatics Lymphangioma and lymphangiosarcoma Tumours of the blood vessel endothelium Haemangioma and Haemangiosarcoma

Tumours of muscle Leiomyoma and leiomyosarcoma 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.Ĭonnective tissue tumours Fibroma and Fibrosarcoma Myxoma and myxosarcoma Spindle cell tumours can be benign (suffix -oma) or malignant (suffix -sarcoma), and will arise from these different cell lines. The name 'spindle cell' refers to the shape of the cell on cytology and histology. Spindle cells are of mesenchymal origin, and form the body's connective tissue, fat, muscle, bone, cartilage and blood vessels.

Spindle cell sarcoma