spindle cell cancer

The spindle cell component usually forms the bulk of the tumor. It is a special type of squamous cell carcinoma of skin Prolonged exposure to the sun’s ultraviolet rays may result in damage of skin DNA, causing the condition. The elongated nuclei have a syncytial pattern with delicate nuclear chromatin and small nucleoli (Figure 24-87) The epithelial cells are more polygonal and are arranged in glands, tubules, trabeculae, cords, papillae, glomeruloid structures, and sheets (Figure 24-87). Pulmonary Spindle Cell Carcinoma is classified as a sarcomatoid carcinoma of lung, which are aggressive tumors, along-with pleomorphic carcinoma, giant cell carcinoma, carcinosarcoma, and pulmonary blastoma; Spindle Cell Carcinoma of Lung is a type of sarcomatoid carcinoma that can develop anywhere in the lung. Lymphocytes and plasma cells may be present. Often the overlying epithelium may be ulcerated, and, because of this, the squamous component may not be seen; rarely, the tumor may be composed entirely of a spindle cell proliferation. Recently, p63 has been reported as a useful marker for SpCC.364, As SpCCs may, in their spindle cell component, exhibit not only vimentin expression but also other mesenchymal filaments, especially myogenic markers, positivity for this marker does not rule out a diagnosis of SpCC.359 Even the absence of keratin positivity cannot be considered evidence against a diagnosis of SpCC, as this may be due to loss of reactivity for antikeratin antibodies due to fixation or embedding procedures or to a phenotypic change of the tumor cells. 2-29).359, Histologically, SpCC typically exhibits areas of SCC and areas of pleomorphic spindle cells. Some of the most common varieties occur in the skin on areas which have been overexposed to the sun. However, if SpCC occurs intraosseously,366 its distinction from sarcomas with a spindle cell appearance may be extremely difficult or even impossible if immunohistochemistry or electron microscopy fail to reveal epithelial characteristics (Fig. Distinguishing between monophasic SpCC and spindle cell sarcomas such as fibrosarcoma and leiomyosarcoma may be more difficult. In the case of SpCC, just as in conventional SCC, the tumor is either ulcerating or directly abutting onto the overlying epithelium without an intervening uninvolved stroma. Occasionally, the spindle cells of the tumor may “stream off”or drop off from the overlying squamous epithelium. A spindle cell sarcoma is a soft tissue sarcoma whose cells exhibit a spindle shape, with an elongated body that is wider … Spindle cell carcinoma. In fact, many previously reported presumed primary soft tissue sarcomas of the esophagus, in retrospect, probably represent spindle cell carcinomas with a predominant undifferentiated soft tissue sarcoma component. {"}Spindle cell{"} is a descriptive phrase that denotes the cellular shape of many of the sarcomas encountered in the adult population. The World Health Organization (WHO) recognizes SpCC as a variant of SCC, and includes the term sarcomatoid squamous cell carcinoma . At other body sites, the label pseudoangiosarcomatous carcinoma has been used for lesions with this histomorphology.365 It must also be mentioned that conventional SCC sometimes contains myxoid areas with enlarged stromal cells exhibiting swollen vesicular nuclei, sometimes showing mitoses. This lesion shares a lot of overlapping features with SpCC, such as clinical presentation as a polypoid or pedunculated mass and histologic features such as spindle cells displaying mitotic figures lying in a myxoid or fibrous stroma; its differentiation from SpCC may prove to be extremely difficult. Typically, spindle cell carcinoma can occur in any connective tissue in the body, although it is more common in some areas than others. 2-30). Any large mass, ulcer, sore, or discolored areas of skin should be checked by a trained medical professional. When keeping this possibility in mind, immunohistochemistry with the appropriate antibodies (e.g., S-100, HMB45) serves to confirm or rule out this diagnosis if melanin is not found in the primary tumor. There is no definite known cause for this type of tumour, but it can sometimes occur as … Squamous differentiation may be present including keratinization and intercellular bridges. There is often dense, desmoplastic fibrosis separating the bands of neoplastic cells into vague lobules and smooth-bordered islands. In the larynx, true sarcomas (with the exception of chondrosarcoma) and benign mesenchymal tumors are very rare. Spindle Cell Squamous Cell Carcinoma (SCC) of Skin is a malignant tumor of skin that is typically seen with a higher frequency in immunosuppressed individuals. Spindle cell carcinoma generally exhibits a worse prognosis than conventional squamous cell carcinoma. Keywords: Spindle-cell carcinoma, Second primary tumor, Synchronous cancer I. Wilson T. Kwong, Thomas J. Savides, in Endosonography (Fourth Edition), 2019. The only known cause of … Although this tumor is considered by some authors to be part of the spectrum exhibited by SpCC,353 its far more complex histology and different predilection site make its classification as a distinct entity separate from SpCC more appropriate. Certain activities or behaviors may make you more prone to spindle cell carcinoma. (A) Small islands and cords of squamous cell carcinoma and dense proliferation of neoplastic spindle cells. Brad W. Neville DDS, ... Angela C. Chi DMD, in Color Atlas of Oral and Maxillofacial Diseases, 2019. Chernock, in Pathobiology of Human Disease, 2014. Sarcomas are tumors that arise in the soft, connective tissues that support and surround the organs and other structures of the body. Sunscreen should be used any time one is out in the sun, not only during the summer months. After surgery, chemotherapy and radiation are the most common treatment methods for spindle cell carcinoma. One of the main symptoms of the disease is a mass or tumor on the skin, sometimes resembling an ulcer or sore. Spindle cell carcinoma and carcinosarcoma are rare, high-grade primary thymic epithelial neoplasms characterized by a spindle cell, sarcomatoid appearance. Spindle cell sarcoma is a rare malignant (cancerous) tumour which can develop in the bone or soft tissue. Spindle cells always express vimentin and often other mesenchymal filaments, such as myogenic markers (smooth muscle actin, muscle specific actin, desmin). For practical purposes, it is advisable to consider a pleomorphic spindle cell lesion occurring at the mucosal surfaces at the UADT to be an SpCC.353. It starts with just a small lump and inflammation and then the symptoms slowly progress as the cancer grows from one stage to another. The converse situation, granulation tissue mimicking SpCC, may occur after ionizing-radiation exposure. 2-35). 17-23).62 The neoplastic cells in these tumors represent spindled (sarcomatoid) epithelial cells by immunohistochemical markers, unlike thymic carcinosarcoma, in which a combination of true sarcomatous and carcinomatous elements is seen.20,21,65 The diagnosis of carcinosarcoma requires the demonstration of a true sarcomatous component admixed with the malignant epithelial elements. Various factors result in spindle cell carcinoma, including genetic predisposition, injury and inflammation. Oscar Lopez‐Nunez, Lea F. Surrey, Rita Alaggio, Karen J. Fritchie, Ivy John, Novel PPP1CB‐ALK fusion in spindle cell tumor defined by S100 and CD34 coexpression and distinctive stromal and perivascular hyalinization, Genes, Chromosomes and Cancer, 10.1002/gcc.22844, 59, 8, (495-499), (2020). Carcinomas are tumors that differentiate into epithelial (or lining) cells, whereas sarcomas are tumors with mesenchymal differentiation, such as fibroblasts. Currently, there is ample evidence that SCC cells can exhibit differentiation toward cells with a mesenchymal phenotype. Within the oral cavity, frequently involved sites include the tongue, gingiva/alveolar mucosa, buccal mucosa, floor of the mouth, and lip. Introduction Spindle cell carcinoma (SpCC) is a rare type of squamous cell carcinoma (SCC) consisting of poorly differentiated elongated epithelial cells that show sarcoma-like proliferation 1 . Spindle cells with a vague storiform pattern of DLBCL are not familiar to pathologists. Wikibuy Review: A Free Tool That Saves You Time and Money, 15 Creative Ways to Save Money That Actually Work. Spindle cell carcinoma is a type of cancer which usually originates in the connective tissues of the body. Spindle cell carcinoma of the breast is a rare sub-type of breast cancer, that falls within the general category of metaplastic breast carcinoma. Similar to conventional SCC, SpCC has been etiologically related to cigarette smoking and alcohol consumption. (b) Higher-power view of the spindle cell (sarcomatoid) component showing poorly formed fascicles of pleomorphic malignant spindle cells (20 ×). Spindle cell cancer is strongly associated with cigarette smoking, as our patient had a significant smoking history as well . Spindle cell carcinoma is a relatively rare form of cancer. Spindle cell carcinomas occur at every head and neck subsite but have a predilection for the oral cavity and larynx. Spindle cell carcinoma exhibits a predilection for older adult males, with a peak in the fifth and sixth decades. The growth pattern and cytomorphology are key features to help determine the line of differentiation of a spindle cell neoplasm. These tumours can be either benign (non-cancerous) or malignant (cancerous). The carcinomatous component may be present only at the base of the polyp and is often overgrown by the more exuberant spindle cell component. Together the two support mixes have the potential to slow the growth of the cancer and boost overall health. De très nombreux exemples de phrases traduites contenant "spindle cell carcinoma" – Dictionnaire français-anglais et moteur de recherche de traductions françaises. The differential diagnosis of spindle cell lymphoma of the uterine cervix includes chronic cervicitis, soft tissue sarcoma, spindle cell carcinoma, spindle cell melanoma and dendritic cell tumour. The characteristic spindle cell phenotype of the neoplastic cells in SpCC is the result of epithelial-mesenchymal transition. Both were T4 tumors and had poor outcomes. When SCC and spindle cells are both observed, the diagnosis of SpCC is easily made. The characteristic spindle cell phenotype of the neoplastic cells in SpCC is the result of epithelial-mesenchymal transition. Only two cases had detectable HPV RNA, only one of which was strongly p16-positive. It is important to note the often abrupt transition between the two components of this tumor. The name “spindle cell” comes from the shape the cells appear to have when viewed through a microscope. They most commonly arise in patients over the age of 40 and are extremely rare - making up just 2-5% of all primary bone cancer cases. Sometimes SpCC may exhibit a very edematous or densely collagenous stroma with only dispersed, slightly pleomorphic spindle cells and an ulcerated surface, and therefore the true neoplastic nature of the lesion is easily overlooked. Nodular fasciitis may exhibit mitotic figures, but they are not atypical; moreover, no cellular pleomorphism is present. Some tumours are made up almost entirely of spindle cells. De très nombreux exemples de phrases traduites contenant "spindle cell" – Dictionnaire français-anglais et moteur de recherche de traductions françaises. Vascular invasion may be seen. Similar to conventional SCC, there is a strong association with a history of cigarette smoking. The shape of the cancer cells is spindle and so it is named spindle cell sarcoma. 2-33). Lauwers and colleagues have shown that the spindle cell component possesses a greater proliferative index and increased aneuploidy, compared with the carcinomatous elements, perhaps providing it with a growth advantage.22 Metastasis may be composed of either, or both, of the cellular components. LewisJr., R.D. (a) Polypoid and ulcerated tumor consisting of sheets of malignant spindle cells with moderate amounts of eosinophilic cytoplasm. The exact treatment options used and in what order will depend on the type of tissue being infected, as some respond better to radiation than chemotherapy. Gastrointestinal spindle cell tumors can arise from the muscularis propria of the esophagus and extend predominantly into the posterior mediastinum, rather than into the esophageal lumen (Fig. 2-34). The cells are spindled, simulate a sarcoma (but stain for cytokeratin), and usually are more aggressive than non-spindle cell carcinomas. The pleomorphic spindle cells usually form the bulk of the lesion; they are arranged in fascicles or whorls. The 31 cases of spindle cell carcinoma were tested for p16 immunohistochemistry and either RNA in situ hybridization or RT-PCR for high-risk HPV. Sometimes SpCC exhibits acantholysis; in this way, spaces lined by pleomorphic cells are formed that may mimic angiosarcoma (Fig. Risk factors for spindle cell carcinoma of the upper aerodigestive tract include tobacco use, alcohol consumption, and previous radiotherapy. Several other terminologies have also been used including polypoid squamous cell carcinoma, … When cells from this type of cancer are viewed under a microscope, they appear spindle-shaped. The tumor can arise anywhere within the upper aerodigestive tract, with a predilection for the larynx and oral cavity. Storiform or giant cell areas may also be present. In some studies, 50% to 60% of affected patients are alive after 5 years.1, Adrián Mariño-Enríquez MD, PhD, Jason L. Hornick MD, PhD, in Practical Soft Tissue Pathology: a Diagnostic Approach (Second Edition), 2019. Microscopically, the SCC component may be well-, moderately- or poorly differentiated, keratinizing or nonkeratinizing, and transition between the two components may be abrupt or gradual. Oral spindle cell carcinomas usually are treated by surgical resection, alone or combined with radiotherapy. Moreover, the observation that stromal fibroblasts as well as endothelial cells may both show these atypical changes may be helpful in distinguishing between SpCC and SCC with atypical stromal features (Fig. Those which are situated right next to an important artery or organ system may be inoperable. Spindle cell tumors will commonly grow back in the same location if they are not removed completely by surgery. SpCC also shows features of epithelial-mesenchymal transition, e.g., up-regulation of transcription repressors (Snail, Slug, SIP and Twist etc.) These are often of connective tissue, such as bones (osteosarcoma), ligaments, blood vessels, and muscle (tumors of the heart). However, sarcomas in the head and neck area located at mucosal surfaces are extremely rare, and, when they do occur, an intervening fibrous layer usually separates the lesion from the overlying epithelium. When cells from this type of cancer are viewed under a microscope, they appear spindle-shaped. The former component may be very scant or limited to noninvasive areas of epithelial dysplasia or carcinoma in situ located at the surface of the tumor, and its identification may require extensive sampling for histologic examination. CASTLE: Similar to thymic carcinoma, the tumor is arranged in solid nests or lobules with an expansive or infiltrative growth of epithelioid cells into the surrounding thyroid parenchyma (Figure 24-88) or adjacent soft tissue and organs (larynx, trachea). Prognosis of the laryngeal SpCC is controversial, but it seems to be favorable for patients with no history of radiation, glottic location and polypoid appearance of the tumor. When occurring in the larynx, the differential diagnosis of SpCC also includes the recently recognized benign proliferative lesion that has been labeled inflammatory myofibroblastic tumor. Lester D.R. This type of cancer can occur on nearly any of the onnective tissues of the body, including the stomach, muscles, and lungs. There is only one published work in the literature that studied HPV in these lesions. The diagnosis of this condition may be challenging. However, spindle cell tumors can appear on the skin of a dog or cat as well, and be rather frustrating. A: Spindle cell carcinoma is a kind of connective tissue cancer where the cells are spindle-shaped. It is more common in areas that have been exposed to the sun, although this is not always the case. Spindle cell (sarcomatoid) carcinoma of the breast is a rare variant of breast cancer that has been classified under the broad rubric of metaplastic carcinoma. In a clinicopathologic review of 78 cases of pleomorphic carcinoma of the lung, 18% of patients had incidental findings on chest X-ray and spindle cell carcinoma was most frequently associated with giant cell carcinoma [1] . spindle cell carcinoma A carcinoma—often squamous cell—which can occur on any epithelial surface (e.g., oral, anorectal, bladder, etc). The carcinomatous component is usually squamous, but rarely, it can be composed of adenocarcinomatous elements as well (Fig. Cytokeratin and vimentin coexpression has been observed in individual tumor cells. and down-regulation of microRNAs implicated in the induction of epithelial-mesenchymal transition. The elderly are more at risk for developing this illness than those under the age of 40, but it is known to strike younger patients as well. The patient may complain of swelling, pain, paresthesia, persistent ulceration, or bleeding. The classic radiologic appearance has been referred to as a cupola sign.17, 19 Histologically, these tumors reveal a biphasic growth pattern, showing areas of carcinoma (well, moderately, or poorly differentiated) with areas of malignant undifferentiated spindle cells. Exact symptoms will depend on where the cancer has spread. The epithelial origin of the spindle cells has been recently confirmed by both immunohistochemical and electron micrographic studies.1, 20 The mesenchymal component may show liposarcoma, rhabdomyosarcoma, leiomyosarcoma, or even chondro- or osteosarcoma differentiation. These tumors can have a CT and endoscopic appearance that more closely resembles that of a posterior mediastinal mass than an esophageal wall mass.85–87 Esophageal spindle cell neoplasms are usually c-kit–negative leiomyomas, although occasionally they can be c-kit–positive gastrointestinal stromal tumors (GISTs).85,86 These tumors have an EUS appearance of a hypoechoic mass with some internal signal and occasional acoustic enhancement, which sometimes makes them difficult to distinguish from cysts.86 Because GISTs are highly metabolically active, they can often be diagnosed and followed with PET scans.88 Although leiomyomas generally are PET-negative tumors, there have been reports of PET-positive esophageal or posterior mediastinal leiomyomas.87 EUS FNA can be used to diagnose both posterior mediastinal leiomyomas and GISTs and can be considered when the distinction between a cyst and a GIST is uncertain. It may quickly spread from one tissue system to another, making it harder to treat. How well they work will depend on whether or not the disease has moved out of the initial area. SETTLE: This is a highly cellular biphasic tumor showing primitive thymus histology, characterized by an admixture of spindle-shaped cells that merge with epithelial cells (Figure 24-86). Very rare RMS with epithelioid and spindle cell morphology, female predominance, marked osseous predilection, ALK expression, EWSR1/FUS-TFCP2 gene fusions, and highly aggressive clinical behavior have recently been recognized with only 23 cases reported in the English language literature. The name of these often ends in “sarcoma.” From: Modern Surgical Pathology (Second Edition), 2009, Nina Zidar, Nina Gale, in Encyclopedia of Cancer (Third Edition), 2019. Spindle cell carcinomas are characterized by a proliferation of spindle cells with varying degrees of atypia and mitotic activity, often exhibiting transitions with areas displaying the features of conventional spindle cell thymoma (Fig. By continuing you agree to the use of cookies. Although reported survival rates vary, one recent study based on epidemiologic data from the United States reported 5-year disease-specific survival of 39% for spindle cell carcinoma of the oral cavity. For a more extensive discussion of the histologic features of nodular fasciitis, inflammatory myofibroblastic tumor of the larynx, melanoma, and spindle cell sarcoma that may be helpful in the differential diagnosis, the reader is referred to their descriptions elsewhere in this book. Once the cancer has spread to other areas, symptoms can include fatigue, nausea, pain, and bruising. Key features assisting in differentiating SpCC from the inflammatory myofibroblastic tumor are the absence of dysplastic or carcinomatous epithelial components, lack of dropping off from the overlying squamous epithelium, and no atypical mitotic figures.367, Sometimes, UADT mucosal melanomas may present as polypoid masses composed of pleomorphic spindle cells. In a cancer stem cell population, planar spindle orientation with symmetric cell division could increase the number of cancer stem cells by producing identical daughter cells with cancer stem cell phenotypes. Spindle cell carcinoma. Treatment of SpCC is the same as for conventional SCC. McDowell's Herbal Spindle Cell Cancer Support Mix can be used in conjunction with other alternative medicines or with orthodox medical treatments such as surgery, radiation and chemotherapy. Smoking or chewing tobacco, sun exposure, alcohol use, and exposure to certain chemicals may raise the risk of developing this and other types of cancer.

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