Post-radiotherapy recurrence of conventional oral squamous cell carcinoma showing sarcomatoid components: an immunohistochemical study

Authors

  • Túlio Morandin Ferrisse Universidade Estadual de São Paulo, Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Medicina Oral https://orcid.org/0000-0002-3520-4690
  • Audrey Foster Lefort Rocha Universidade Estadual de São Paulo, Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Medicina Oral https://orcid.org/0000-0002-0361-7407
  • Maria Letícia de Almeida Lança Universidade Estadual de São Paulo, Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Medicina Oral https://orcid.org/0000-0001-5768-9281
  • Heitor Albergoni Silveira Universidade Estadual de São Paulo, Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Medicina Oral https://orcid.org/0000-0002-6724-3504
  • Luciana Yamamoto Almeida Universidade Estadual de São Paulo, Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Medicina Oral https://orcid.org/0000-0001-5403-4052
  • Andreia Bufalino Universidade Estadual de São Paulo, Faculdade de Odontologia de Araraquara, Departamento de Diagnóstico e Cirurgia, Medicina Oral https://orcid.org/0000-0002-6714-6253
  • Jorge Esquiche León Universidade de São Paulo, Faculdade de Odontologia de Riberão Preto, Departamento de Estomatologia, Saúde Coletiva e Odontologia Legal, Patologia Oral https://orcid.org/0000-0002-9668-5870

DOI:

https://doi.org/10.4322/acr.2020.219

Keywords:

Squamous cell carcinoma, Squamous Cell Carcinoma of Head and Neck, immunohistochemistry, radiotherapy

Abstract

Spindle cell squamous cell carcinoma (SpSCC) is a rare biphasic malignant neoplasm, uncommonly affecting the oral cavity. The SpSCC diagnosis is difficult, especially when it exhibits inconspicuous morphology, inadequate tissue sampling, or association with an exuberant inflammatory reaction. Post-radiotherapy recurrent SpSCC occurring at the same site of conventional SCC is a rare phenomenon. A 59-year-old man was complained of “painful injury on the tongue” with 20 days of duration. He reported smoking and alcohol consumption. Medical history revealed conventional SCC on the tongue treated with surgery and radiotherapy 10 years ago. Intraoral examination showed a polypoid lesion with ulcerated areas, measuring 3 cm in diameter, on the tongue and floor of the mouth, at the same site of previous conventional SCC. The microscopical analysis showed small foci of carcinomatous component admixed with an exuberant inflammatory reaction. Immunohistochemistry highlighted the sarcomatoid component. Both malignant components were positive for EMA, CD138, p40 (deltaNp63), p63, and p53. Moreover, CK AE1/AE3 evidenced the carcinomatous component, whereas vimentin stained the sarcomatoid component. The Ki-67 was >10%. The current case emphasizes the importance of immunohistochemistry in the differential diagnosis of SpSCC from mimics and documents a rare complication of Ionizing Radiation.

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Published

2021-01-04

How to Cite

Ferrisse, T. M. ., Rocha, A. F. L., Lança, M. L. de A. ., Silveira, H. A. ., Almeida, L. Y. ., Bufalino, A. ., & León, J. E. . (2021). Post-radiotherapy recurrence of conventional oral squamous cell carcinoma showing sarcomatoid components: an immunohistochemical study. Autopsy and Case Reports, 11, e2020219. https://doi.org/10.4322/acr.2020.219

Issue

Section

Clinical Case Report and Review