Sarcomatoid Carcinoma: ‘‘A Surgeons Nightmare’’
Received: 18 November 2017 / Accepted: 4 May 2018
Ó The Association of Oral and Maxillofacial Surgeons of India 2018
Abstract Sarcomatoid carcinoma (SC) is a rare and unique
disease of the oral cavity. It is a biphasic squamous cell
carcinoma with sarcoma-like characteristics. It is a strik-
ingly aggressive lesion with a rapid rate of growth and a
high rate of metastasis. Diagnosing a sarcomatoid carci-
noma may present a challenge; most can only be ascer-
tained by immunohistochemical study. An aggressive
treatment plan should be devised for this uncompromising
disease with a readiness to accept the dire outcome. We
hereby present a case of a 50-year-old male patient, with no
history of deleterious habit, diagnosed with SC of the
buccal mucosa that proved to be fatal.
Keywords Spindle cell carcinoma Á Rare tumour Á
Collision tumour Á Biphasic Á Pseudocarcinoma Á
Reconstruction local ﬂaps
Spindle cell carcinoma (SC) is a rare, unusual variant of
squamous cell carcinoma that has a biphasic characteristic.
It accounts for 3% of all head and neck tumours of
epithelial origin. It is a poorly differentiated tumour, with
cells proliferating as a squamous carcinoma along with
spindle-like cell growth, which are of epithelial origin. The
exact origin of the tumour is of a certain controversy
amongst the authors. This is exhibited in the numerous
names given to the lesion viz, sarcomatoid carcinoma,
fusiform cell carcinoma, carcinosarcoma, pleomorphic
carcinoma, pseudosarcoma, collision tumour, Lane tumour
[1, 3]. SC affects mostly the larynx, the nasal cavity,
hypopharynx, oesophagus, trachea, breast, oral mucosa and
lungs. In lungs, a spindle cell carcinoma is rare, mostly
associated with smokers and has a poor prognosis .
WHO coined the term as spindle cell carcinoma. It has a
male predilection in a ratio of 7:1, seen mostly in the 6th to
8th decade of life . Deleterious habits like smoking,
alcohol consumption and tobacco chewing or any history
of previous irradiation multiplies the chance of occurrence
of the disease .
There are no deﬁnite clinical signs that can direct
towards the diagnosis of SC although some telltale signs
may be present. Diagnosis is mainly histopathological
which is conﬁrmed by immunohistochemistry. Surgery is
the primary treatment option; adjuvant chemotherapy and
radiotherapy may be required.
Owing to its aggressive nature and high chances of
distant metastasis, the prognosis is not favourable . We
hereby present a case of spindle cell carcinoma of the right
A 50-year-old male patient reported with a chief complaint
of swelling on the right buccal mucosa since a month.
Initially swelling was of the size of a peanut which
& Abhishek Khatua
Department of Oral and Maxillofacial Surgery, Vokkaligara
Sangha Dental College and Hospital, Bangalore, India
J. Maxillofac. Oral Surg.