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Spindle cell carcinoma is a biphasic tumor consisting of a squamous cell carcinoma component and a sarcomatoid component of spindle cells. We present a case of spindle cell carcinoma arising as a polypoid mass in the tongue of a 66-year-old man, describe the results of immunohistochemical analysis of the epithelial-mesenchymal transition, and review 38 cases reported in the literature to discuss the clinical and therapeutic aspects of this tumor. An elastic-soft polypoid mass approximately 20 × 20 mm in diameter was located in the left margin of the tongue, and an irregular ulcer was noted posterior to the mass. An excisional biopsy was performed under local anesthesia. Histopathological examination of the mass revealed spindle-shaped cells that were immunohistochemically positive for keratin and vimentin, and the mass was diagnosed as spindle cell carcinoma. Histopathological examination of the ulcer revealed squamous cell carcinoma. In the spindle cell carcinoma cells, E-cadherin expression was down-regulated as compared with the squamous cell carcinoma cells, although Snail expression in the spindle cell carcinoma cells was up-regulated. These results suggest that epithelial-mesenchymal transition might play an important role in the pathogenesis of spindle cell carcinoma.

A case of lingual spindle cell carcinoma adjacent to squamous cell carcinoma