The concept at that time was that these lesions only seemed to occur in the jaws, they were found in the first two decades of life, more frequently in females approximately 2. In a previous series of laryngeal malignancy, about 1%. Differential diagnosis for spindle cell lesions presenting at uadt mucosal sites. Pigmented lesions of the oral cavity pocket dentistry. Case report spindle cell myoepithelial carcinoma of the oral cavitya report of two cases shubhada v. Spindle cell carcinoma of the oral cavity and oropharynx. The oral cavity is a complex organ comprising muscle, glands, teeth, and specialized sensory receptors.
Reactive nodules of the oral cavity are fairly common and are a diverse group. Aug 09, 2017 spindle cell lesions of oral cavity part iii 1. In most cases, lesions of the oral cavity reflect locally confined processes, but on occasion, they are manifestations of systemic disease. Spindle cell neoplasms can affect the oral cavity and it is often very difficult for the oral pathologists to differentiate it from other similar microscopic simulates. More recently, a simple working type classification was proposed by the author shamim 20 for the spindle cell neoplasms of the oral cavity on the basis of predominance of spindle cells in the histopathology of the lesions of the oral cavity. Seminar on spindle cell tumors of the oral cavity part i by. Granular cell lesions of the oral mucosa, jaws, and salivary glands constitute a heterogeneous group of lesions which may be either odontogenic, salivary gland, or metastatic in origin.
It is most frequently encountered in the larynx, and also occurs in the nasal cavity, hypopharynx, oral cavities, esophagus, trachea, skin and breast. Thirteen spindlecell tumors of the upper respiratory tract, oral cavity, and skin of face have been studied with light and electron microscopy. In the oral cavity, the origin of the spindle cell neoplasms may be traced to. Tumors of the skin in dogs merck veterinary manual. Spindle cell lesions can occur in head and neck skin, in the soft tissues of the scalp, orbit, and neck, and along the upper aerodigestive tract uadt mucosa. The diagnosis and management of giant cell lesions of the. Areas prone to ks in the adult aids population include. Field manual for the microscopic diagnosis of proliferative liver and skin lesions in the brown bullhead 11 a b b a c a a b d e b a e f a b e figure 11. Spindle cell myoepithelial carcinomas need to be differentiated from other spindle cell lesions of the oral cavity like sarcomatoid squamous carcinoma, melanoma, nerve sheath sarcoma, etc. Combining five major spcc clinicopathologic studies, 18% of the 326. Spindle cell lipoma scl is a rare benign adipocytic tumor typically arising in the upper neck, back, and shoulders and less commonly in the oral cavity. To our knowledge, only three cases of multiple scls of the tongue have been reported previously. The oral cavity is lined with moist stratified epithelium which shows characteristic variations of the different regions 1. Chondroblastic osteosarcoma with neoplastic cartilage merging with tumor bone.
Manual for the microscopic diagnosis of proliferative liver. However, the lesion often responds to antifungal treatment with nystatin, fluconazole, or clotrimazole as a suspension or oral troches. Note a plaque is flatter than a papillaryverrucous lesion. Granules in granular cell lesions of the head and neck. Spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and mesenchymal components. Thirteen spindle cell tumors of the upper respiratory tract, oral cavity, and skin of face have been studied with light and electron microscopy. Thus, an understanding of the various disorders and substances that can contribute to oral mucosal coloration is essential for the appropriate evaluation, diagnosis, and management of. Aidsks spindle cells express neuroectodermal stem cell marker nestin and oral msc marker cd29, suggesting the oralcraniofacial msc lineage of aidsassociated ks. Differentiate different parts of the oral cavity 2. The differential diagnosis of lesions or abnormalities of. The histologic picture shows a range of variations and the observation of morphological features is important to distinguish this lesion from other fusiform tumors. Describe the blood and nerve supply of mucosa and muscles of palate and tongue 3.
The oral manifestations consist of red lesions in the form of petechiae, ecchymoses, or even hematomas, usually located on the palate and buccal mucosa. Thermal burns to the oral mucosa are fairly common, usually due to contact with very hot foods, liquids, or hot metal objects. Five cases of spindle cell lipoma have been reported in the oral cavity, two af fecting the anterior floor of the mouth, two the tongue, and one the hard pal ate4,81 a case reported to occur in the cheek2 is not included, as it was not specifically stated that the tumor oc curred in the mouth. Presence of this tumor type in the tongue has rarely been reported. Images in clinical medicine from the new england journal of medicine lesions in the oral cavity. Spindle cell squamous carcinoma scsc is defined as a tumor composed of conventional scc in situ or invasive carcinoma associated with a. Locally aggressive tumor rare tumor of young adults mainly. Differential diagnosis of white lesion of oral cavity. Journal of the canadian dental association october 2003, vol. In the oral cavity, the origin of the spindle cell neoplasms may be traced to epithelial, mesenchymal and odontogenic components. In the oral cavity local symptoms and findings of leukemia include paleness of the oral mucosa with gingival bleeding that develops into painless gingival hyperplasia, petechiae, hemorrhages, and ulcerative necrotic lesions because of their clinical importance, all such lesions deserve the full attention of the dental doctors. Combining the results of five major related studies 17.
Spindle cell carcinoma of the oral cavity 65e paper. Five were primary neoplasms, and 8 had recurred following radiation therapy. Spindle cell squamous carcinoma scsc is defined as a tumor composed of conventional scc in situ or invasive carcinoma associated with a malignant spindle cell stromal component. The most common fibrous proliferative lesions of the oral cavity are fibroma 61%, peripheral ossifying fibroma 22%, pyogenic granuloma 12%, and peripheral giant cell granuloma 5%. Recently characterized soft tissue tumors that bring biologic insight. Spindle cell myoepithelial carcinoma of the oral cavity a.
The present series has also shown that the mean age of occurrence of these lesions is 31. A rare spindle cell neoplasm bernardoferreira brasileiro 1, pauloricardosaquete martinsfilho 1, martarabello piva, luizcarlosferreira da silva 1, cassianofranciscoweege nonaka 2, marciacristinada costa miguel 2 1 department of oral pathology, dentistry school, federal university of sergipe, sergipe. With the exception of ks, there was a general paucity of malignant soft tissue tumors. Ernest borges road, parel, mumbai400017, maharashtra, india b department of surgery, tata memorial hospital, parel.
Spindle cell myoepithelial carcinoma of the oral cavitya. This age distribution is in accordance with age distribution reported in previous studies 11. The diagnosis often represents a clinicalpathological. Contents introduction causes for development of spindle cell tumors various classifications proposed for spindle cell lesions clinical and histological features of. The differential diagnosis of lesions or abnormalities of the oral cavity will help nondental healthcare providers hcps to refer atrisk patients to the appropriate provider so they can be reexamined more closely. A rare spindle cell neoplasm bernardoferreira brasileiro 1. Skin tumors are diagnosed more frequently than other tumors in animals in part because they are the most easily seen tumors and in part because the skin is constantly exposed to many tumorcausing factors. Spindle cell lesions of the head and neck are quite diverse with great clinical and biological heterogeneity. Identify the effect of nerve paralysis on those muscles and their related function 4. Typically afx cells shade off at the periphery to blend with the surrounding dermal fibroblasts.
Spindle cell carcinoma and other atypical spindle cell lesions of the head and neck. August 4, 2016these lesions must be differentiated from the papillaryverrucous lesions, whose appearance is often white or white and red, is shown in this section and for which there is a different flowchart. Primary site age gender classification primary pulmonary metastatic average timesurvival. Ernest borges road, parel, mumbai400017, maharashtra, india. This paper presents a brief overview of nonsquamous cell oral. For most animals, the orosensory and oromotor apparatus is critical for successful defense, reproduction, exploration, nutrition, and vocalization. Most common tumor oral cavity, nodular mass, dense, fibrous ct covered by sse, not encapsulated, sessile. Discussion whether these biphasic neoplasms of the oral cavity represent a squamous cell carcinoma associated with an atypical,benign,reactive connective tissue process pseudosarcoma, a combination or collision growth of a carcinoma and a sarcoma carcinosarcoma,or a squamous cell carcinoma with a peculiar spindle ccl 532ellis and coriooral. Well circumscribed interlacing bundles of spindleshaped cells with wavy nuclei, in a fibrous stroma 5. Hence, we made an attempt to categorize round cell tumors of the oral cavity in table 1 based on the predominance of round cells in the histopathology of the lesions of the oral cavity. Importantly, the oral manifestations of these potentially lifethreatening disorders can mimic an array of idiopathic, reactive, and benign neoplastic lesions.
Recently characterized soft tissue tumors that bring. The differential diagnosis of lesions or abnormalities of the. Cytokeratin, sarcomatoid, spindlecell lesion, squamous cell carcinoma, vimentin. To download additional copies of this brochure, go to. Tumors of the skin in dogs dog owners merck veterinary manual. A rare case report richa wadhawan 1, nisheeth saawarn 2, swati saawarn 3, dharmendra sharma 4 1 reader, department of oral medicine and radiology, institute of dental education and advance studies, gwalior, madhya. The spindle cell neoplasms of the oral cavity ncbi. Skin tumors are diagnosed more frequently than other tumors in animals in part because they are the most easily seen tumors and in part because the skin is constantly exposed to many tumorcausing factors in the environment. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Oct 29, 2016 importantly, the oral manifestations of these potentially lifethreatening disorders can mimic an array of idiopathic, reactive, and benign neoplastic lesions.
Hepatocellular carcinoma in the liver of brown bullhead. Manual for the microscopic diagnosis of proliferative. Multiple white lesions that do not rub off should be noted in patient records, including the location of the lesions. Nonsquamous cell malignant tumours of the oral cavity. Gastrointestinal tract spindle cell lesionsjust like real estate, its all. Reference to a location in the oral cavity or proximity to dentition for example, lesion is located 2 mm. Granular cells in these proliferations most commonly are the result of lysosomal accumulation, aging, degenerative, metabolic alteration, increased apoptosis, cytoplasmic autophagocytosis, and many more. Spindle cell carcinoma spcc, also known as sarcomatoid carcinoma, is a rare malignancy of the head and neck regions. Tumors affecting the skin or the tissue just under the skin are the most commonly seen tumors in dogs. Scribd is the worlds largest social reading and publishing site. Spindle cell lipoma scl is an uncommon and histologically distinct variant of lipoma, initially described by enzinger and harvey. In total, benign neural tumors accounted for 21% of all cases seen.
However, the lesion often responds to antifungal treatment with nystatin, fluconazole, or clotrimazole as a suspension or. Carcinoma or sarcoma clinical cancer investigation journal. Oral mesenchymal stem cells can be efficiently infected by kshv, suggesting these cells might be primary target cells for kshv infection in oral cavity. Terms commonly used to describe oral lesions fixed a lesion that is nonmobile and firmly attached to the underlying structures mobile a movable lesion that does not appear to be connected to underlying structures indurated hard and firm tissue palpation that would normally be soft exophytic a lesion that appears to be growing outward from the mucosa. Foci of neoplastic cells a are observed throughout the normal hepatic parenchyma b. This classification was based on the predominance of spindle cells in the histopathology of the lesions of the oral cavity. It extends from the vermilion border of the lips to the oropharynx and is separated from the oropharynx by. Spindle cell lipoma of the oral cavity sciencedirect. Immunohistochemistry should be helpful in this differentiation. This is a rare entity with only 18 cases reported in the oral cavity.
It is considered to be a biphasic tumor made up of cells from squamous and spindle cells carcinoma with a sarcomatous aspect, but of epithelial origin. Seminar on spindle cell tumors of the oral cavity part iii by. Misdiagnosis included benign and malignant spindle cell lesions of nerve tissue or smooth muscle origin, such as neurofibroma. Spindle cell lesionsneoplastic or nonneoplastic spindle cell. Spindle cell lesions of oral cavity part iii slideshare.
Squamous cell carcinoma of the upper aerodigestive tract. This may reflect either the true rarity of these tumors in the oral cavity or the practice patterns whereby many malignant spindle cell tumors are seen in more specialized pathology services. Patients with spindle cell carcinoma in the oral cavity. Spindle cell carcinoma in the oral cavity and oropharynx is potentially aggressive and has a propensity for recurrence and metastases 3. Bagwan a, tanuja shet a, prashant bavi a, anil dcruz b a department of pathology, tata memorial hospital, dr. In this group, ks frequently assumes an aggressive course.
If it has been established that the lesions are nonpapillaryverrucous then the first question would be. May be superficially invasive with no apparent connection to atypical spindle cells or a classic squamous cell carcinoma present deep within sarcomatoid component has variable squamous and spindle cell differentiation with bone or cartilage. Spindle cell myoepithelial carcinoma of the oral cavitya report of two cases shubhada v. Recently characterized soft tissue tumors that bring biologic. Myofibroma is an uncommon spindle cell neoplasm rarely found in oral cavity. It usually occurs as a solitary, subcutaneous, and wellcircumscribed lesion in the posterior neck, shoulders, and back of older men. Some are malignant while many others are benign or simply reactive in nature. Aug 09, 2017 introduction these lesions are highly variable both biologically and clinically clinical, histological, and immunohistochemical some times electron microscopy predominant cells spindle cells altered spindle cells ranging from simple reactive to malignant lesions uncommon oral cavity, common in other sites of the. The pri mary lesions were superficially located, and, in light microscopic sections, sites.
Similar to spindle cell lipoma, these lesions often show loss of rbnote that. Giant cell lesions of the jaws were separated out from other jaw lesions by jaffe in 1953 when they were termed giant cell reparative granulomas. May 05, 2014 spindle cell neoplasms can affect the oral cavity. Cancers from distant organs such as breast, lung and prostate may metastasize to the oral cavity. Nov 30, 2015 oral spindle cell lipoma is a rare benign lipomatous tumor. We describe a rare case of multiple scls of the tongue. Multiple mott cells in periapical lesion of the oral cavity. The cause of an oral cavity lesion can usually be identified by the history and the physical examination. Au masilana a, khammissa rag, lemmer j, feller l so j investig clin dent. Oral cavity anatomical and physiological specificities. Pdf spindle cell carcinoma is a rare biphasic tumor consisting of epithelial and mesenchymal components. Sarcomatoid carcinoma sc is an unusual and aggressive variant of squamous cell carcinoma, which frequently recurs and metastasizes.