Clinicopathologic features and outcome of head and neck mucosal spindle cell squamous cell carcinoma Journal Article
| Authors: | Prieto-Granada, C. N.; Xu, B.; Alzumaili, B.; Haroon Al Rasheed, M. R.; Eskander, A.; Enepekides, D.; Patel, S. G.; Stevens, T. M.; Dogan, S.; Ghossein, R.; Katabi, N. |
| Article Title: | Clinicopathologic features and outcome of head and neck mucosal spindle cell squamous cell carcinoma |
| Abstract: | Spindle cell squamous cell carcinoma (SpC-SCC) is rare, accounting for 0.4–4% of head and neck (HN) SCCs. Better understanding of HN SpC-SCC clinicopathologic characteristics, especially features that predict outcome, is needed. We present a clinicopathologic review of 71 HN mucosal SpC-SCC from three tertiary centers. The patient population showed a median age of 63 years (range 20–91), slight male predominance (M:F = 1.6:1), and a preponderance of smokers/ex-smokers (45/71, 64%). Most lesions involved oral cavity (42/71, 59%), especially oral tongue (n = 18), and larynx (n = 20, 28%). Polypoid/exophytic growth and surface ulceration were seen in 60% and 86% of cases, respectively. Histologically, most tumors showed sarcoma-like pattern (65/70, 93%), the remaining exhibiting granulation tissue-like or fibromatosis-like patterns, and 5 lesions showed osteosarcomatous/chondrosarcomatous elements. Most tumors (53/71, 74%) showed a conventional SCC (C-SCC) component, keratinizing (86%) or non-keratinizing/basaloid (14%). Nodal metastases, seen in 22 (31%) of resection specimens, showed SpC-SCC and/or C-SCC histomorphology. By immunohistochemistry, 76% of lesions showed immunoreactivity for keratin and 62/60% of lesions were p40/p63 positive. Ki-67 proliferation index ranged from 5 to 70%. Follow-up was available on 69 patients, median of 1.1 years from the time of SpC-SCC diagnosis. The 3-, 5-, and 10-year disease-specific survival (DSS) was 62, 37, and 12%, respectively. AJCC pN stage was an independent prognostic factor for DSS and distant metastasis-free survival (DMFS), whereas the presence of C-SCC was independently associated with improved DMFS. HN SpC-SCC is rare and might be diagnostically challenging. AJCC pN stage and co-existing C-SCC component appear to be prognostically relevant. © 2021, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature. |
| Keywords: | immunohistochemistry; osteosarcoma; adult; cancer survival; human tissue; aged; cancer surgery; major clinical study; clinical feature; histopathology; cancer recurrence; follow up; lymph node metastasis; cancer diagnosis; lymph node dissection; ki 67 antigen; basal cell carcinoma; tumor biopsy; cell differentiation; immunoreactivity; retrospective study; sarcoma; multicenter study; cancer cell; cancer size; sarcomatoid carcinoma; protein p63; cervical lymph node; spindle cell carcinoma; chondrosarcoma; larynx; head and neck; tongue; disease specific survival; perineural invasion; ulcer; mouth cavity; cytokeratin ae1; cytokeratin ae3; hypopharynx; oropharynx; granulation tissue; protein p40; surgical margin; head and neck squamous cell carcinoma; keratin; fibromatosis; wide excision; clinical outcome; tumor thickness; incisional biopsy; keratinization; depth of invasion; proliferation index; lymph vessel metastasis; distant metastasis free survival; never smoker; prognosis; human; male; female; article; current smoker; ex-smoker; spindle cell squamous cell carcinoma |
| Journal Title: | Virchows Archiv |
| Volume: | 479 |
| Issue: | 4 |
| ISSN: | 0945-6317 |
| Publisher: | Springer |
| Date Published: | 2021-10-01 |
| Start Page: | 729 |
| End Page: | 739 |
| Language: | English |
| DOI: | 10.1007/s00428-021-03117-2 |
| PROVIDER: | scopus |
| PUBMED: | 33982148 |
| PMCID: | PMC9425732 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 2 November 2021 -- Source: Scopus |
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