Abstract
Spindle cell carcinoma (SpCC) is a rare tumor, which occurs in upper respiratory tract, mainly in larynx. This study aimed to review the clinical and pathological characteristics for diagnosis and prognosis. Retrospective cohort study. All patients with SpCC in upper respiratory tract treated for curative intent was included. All patients were reviewed in search of epithelial component and immunohistochemistry when not found. It was evaluated rate of recurrence and disease-free survival with univariate and multivariate analysis with Kaplan Meier and Cox Regression model adjusted to propensity score indexes (PSI) according to age, gender, site of tumor, stage, surgical treatment, status of margins of surgical resection, lymphatic invasion. There were 16 cases of SpCC.31% were diagnosed with light microscopy and others with immunohistochemistry for epithelial marker. Disease-free survival was higher in early stage disease in univariate and multivariate analysis, as the main prognostic factor. Surgical treatment increases in 2.54 the rate of survival. The SpCC is a rare tumor considered a highly malignant variant of squamous cell carcinoma. It has male predominance and tobacco use as risk factors. Its treatment should follow the same recommendations for squamous cell carcinoma, with surgery as the maintain treatment. Immunohistochemistry is an adjuvant important tool for diagnosis of SpCC.
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References
Virchow V. Die Krankhaften Geschwfilste, vol 2. Berlin, Germany: A. Hirschwald; 1864-1865:181-182.
Gupta R, Singh S, Hedau S, Nigam S, Das BC, Sigh I, Mandal AK (2007) Spindle cell carcinoma of head and neck: an immunohistochemical and molecular approach to its pathogenesis. J Clin Pathol 60:472–475
Figi FA (1933) Sarcoma of the larynx. Arch Otolaryngol Head Neck Surg 18:21–33
Gerry D, Fritsch VA, Lentsch EJ (2014) Spindle cell carcinoma of upper aerodigestive tract: an analysis of 341 cases with comparison to conventional squamous cell carcinoma. Ann Otol Rhinol Laryngol 123(8):576–583
Olsen K, Lewis JE, Suman VJ (1997) Spindle cell carcinoma of the larynx and hypopharynx. Otolaryngol Head Neck Surg 116(1):47–52
Bishop JA, Montgomery EA, Westra WH (2014) Use of p40 and p63 immunohistochemistry and human papillomavirus testing as ancillary tools for the recognition of head and neck sarcomatoid carcinoma and its distinction from benign and malignant mesenchymal processes. Am J Surg Pathol 38(2):257–264. https://doi.org/10.1097/PAS.0000000000000119
Choi HR, Sturgis EM, Rosenthal DI, Luna MA, Batsakis JG, El-Naggar AK (2003) Sarcomatoid carcinoma of the head and neck: molecular evidence for evolution and progression from conventional squamous cell carcinomas. Am J Surg Pathol 27(9):1216–1220
Choi HR, Roberts DB, Johnigan RH, Sturgis EM, Rosenthal DI, Weber RS, Luna MA, Batsakis JG, El-Naggar AK (2004) Molecular and clinicopathologic comparisons of head and neck squamous carcinoma variants: common and distinctive features of biological significance. Am J Surg Pathol 28(10):1299–1310
Chang NJ, Kao DS, Lee LY, Chang JW, Hou MM, Lam WL, Cheng MH (2013) Sarcomatoid carcinoma in head and neck: a review of 30 years of experience--clinical outcomes and reconstructive results. Ann Plast Surg 71(Suppl 1):S1–S7. https://doi.org/10.1097/SAP.0000000000000069.
Lewis JS, Ritter JH, El-Mofty S (2005 Nov) Alternative epithelial markers in sarcomatoid carcinomas of the head and neck, lung, and bladder-p63, MOC-31, and TTF-1. Mod Pathol 18(11):1471–1481
Viswanathan S, Rahman K, Pallavi S, Sachin J, Patil A, Chaturvedi P, D'Cruz A, Agarwal J, Kane SV (2010) Sarcomatoid (spindle cell) carcinoma of the head and neck mucosal region: a clinicopathologic review of 103 cases from a tertiary referral cancer Centre. Head Neck Pathol 4(4):265–275. https://doi.org/10.1007/s12105-010-0204-4
Dubal PM, Marchiano E, Kam D, Dutta R, Kalyoussef E, Baredes S, Eloy JA (2015) Laryngeal spindle cell carcinoma: a population-based analysis of incidence and survival. Laryngoscope. 125(12):2709–2714. https://doi.org/10.1002/lary.25383 Epub 2015 May 21
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (2010) Head and neck. In: Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A (eds) Cancer staging handbook from the AJCC Cancer staging manual, 7th edn. Springer, New York, pp 21–100
Ha Lan TT, Chen SJ, Arps DP, Fullen DR, Patel RM, Siddiqui J, Carskadon S, Palanisamy N, Harms PW (2014) Expression of the p40 isoform of p63 has high specificity for cutaneous sarcomatoid squamous cell carcinoma. J Cutan Pathol 41(11):831–838. https://doi.org/10.1111/cup.12387
Virchow V. Die Krankhaften Geschwfilste, vol 2. Berlin, Germany: A. Hirschwald; 1864-1865:181-182.
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Amanda Bueno de Araújo, Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.; Carlos Takahiro Chone, Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work; drafting the work or revising it critically for important intellectual content; final approval of the version to be published;agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Agrício Nubiato Crespo, final approval of the version to be published;agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; Maria Claúdia Mota Pedroso, final approval of the version to be published;agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Flávio Mignone Gripp, final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Thiago Luís Infanger Serrano, final approval of the version to be published;agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved; Albina Altemani, final approval of the version to be published;agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Fernanda Viviane Mariano final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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de Araújo, A.B., Serrano, T.L.I., Pedroso, M.C.M. et al. Clinicopathologic Diagnostic and Prognostic Factors of Spindle Cell Carcinoma of Upper Airway. Pathol. Oncol. Res. 26, 1097–1104 (2020). https://doi.org/10.1007/s12253-019-00654-9
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DOI: https://doi.org/10.1007/s12253-019-00654-9