Palliative Management of Sarcomatoid Buccal Carcinoma by Laser Ablation

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2021/46409.14555 ◽

2021 ◽

Author(s):

Rusy S Bhalla ◽

Seemantini Bhalla

Keyword(s):

Laser Ablation ◽

Oral Cavity ◽

Sarcomatoid Carcinoma ◽

Second Primary ◽

Malignant Tumours ◽

Laser Technique ◽

Diagnostic Dilemma ◽

Neck Disease ◽

Indian Male ◽

Aggressive Variant

Sarcomatoid change in buccal carcinoma is a rare and aggressive variant of Squamous Cell Carcinoma (SCC) and most often a diagnostic dilemma. There are some reports of second primary sarcomatous tumours in the oral cavity and nasopharynx post irradiation. Synchronous and metachronous lesions in this category in the oral cavity and neck have also been reported. Spindle cell neoplasms comprise a diverse collection of benign and malignant tumours. These tumours are uncommon in the oral cavity, accounting for <1% of all tumours of oral region. It is an unusual aggressive variant that frequently recurs and metastasises. Herein, the author present a case report of a 45-year-old Indian male with a sarcomatoid lesion according to his previous reports in the oral cavity of five months duration at presentation. The patient presented late as he was not willing for surgery and hence a very extensive 9×5 cm lesion was observed. In addition, he had trismus, multiple, firm, fixed lymph nodes in the ipsilateral neck. The biopsy of the oral cavity tumour showed a histological appearance of spindle shaped cells with penetration of basement membrane suggestive of sarcomatoid carcinoma. He was treated with repeated ablative laser technique for the primary and metastatic nodes in the neck disease and chemotherapy. The patient resumed normal activities 14 days after the laser ablation.

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Gingival cancer: 11 year follow-up at Karolinska University Hospital (2000-2010).

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.5536 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 5536-5536

Author(s):

Rusana Simonoska

Keyword(s):

Oral Cavity ◽

Neck Dissection ◽

Primary Tumor ◽

University Hospital ◽

Second Primary ◽

Occult Metastasis ◽

Presenting Symptoms ◽

Lower Jaw ◽

Regional Metastasis ◽

Neck Disease

5536 Background: In Sweden, approximately 500-600 cases of oral cancer are diagnosed every year. These include cancer of the gingiva, retromolar trigonum, bucca, hard palate, tongue and floor of the mouth. Each year, around 15 cases of gingival cancer (GC) are diagnosed in the Stockholm region. The goal of this study was to study the onset of symptoms, treatment, prognosis, and sequelae of GC in order to optimize the treatment. Methods: The study consists of a retrospective review of medical records of all diagnosed cases of GC in Stockholm region between 2000-2010, identified through the ENT-clinic Karolinska Hospital patient database. Results: Our retrospective study comprised 156 patients diagnosed with GC. The average age was 72 years sharing equally between the sexes, 50% were smokers. 98% had a squamous cell carcinoma (scc). Presenting symptoms were often lump or ulceration in the gums, pain, bleeding or discomfort/misfit of dentures. Around 30% had premalignant lessons in the oral cavity before diagnosis. 3/4-th of all GC was localized in the lower jaw. 66% of the GC-patients presented as aT4 cancer. At presentation, 26% had a regional metastasis and of those 90% had their primary tumor in the lower jaw. Six cases had bilateral neck disease. 81% of the patients with regional metastasis had low to medium grade of scc differentiation of the primary tumor. 84% of all patients with regional metastasis had a T4 primary tumor. Neck dissection was performed in 38% (n=59). Of these 35 cases where staging neck, i.e. N0 at presentation and in 7 cases (20%) a positive neck disease was found. The risk for second primary was 15%. The overall 5-year survival was 24%. Conclusions: Advanced age and high number of T4 cancer at diagnosis partly explains the poor survival statistics. Almost 30% of the patients in our material have had premalignant lessons in the oral cavity before the cancer diagnosis and are at high risk for new tumors (second primary); therefore patients with GC should be followed up for at least 5 years, possibly longer in the presence of premalignant lessons. GC of the lower jaw is more likely to metastasize than GC of the upper jaw. Due to 20% occult metastasis occurrence in the staging neck cases, we recommend staging neck dissection for patients with GC.

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Sarcomatoid Carcinoma of the Oral Cavity: A Diagnostic Dilemma

Case Reports in Dentistry ◽

10.1155/2017/7495695 ◽

2017 ◽

Vol 2017 ◽

pp. 1-6

Author(s):

Anshul Mahajan ◽

Sujata Mohanty ◽

Sujoy Ghosh ◽

Aadithya B. Urs ◽

Nita Khurana ◽

...

Keyword(s):

Oral Cavity ◽

Epithelioid Sarcoma ◽

Sarcomatoid Carcinoma ◽

The Body ◽

Incisional Biopsy ◽

Diagnostic Dilemma ◽

Tissue Mass ◽

Biopsy Report ◽

Supraomohyoid Neck Dissection ◽

Stromal Element

Sarcomatoid carcinoma (SC) is a rare variant of squamous cell carcinoma which is characterized by a dysplastic epithelial component and a stromal element with invasive fusiform or spindle-shaped cells. The clinical and histopathologic characteristics make it very difficult to distinguish SC from epithelioid sarcoma (ES). We present a case of a 51-year-old man with a soft tissue mass in the oral cavity diagnosed as proximal variant of epithelioid sarcoma on incisional biopsy. A thorough radiologic examination was conducted to rule out the possibility of a primary elsewhere in the body. Supraomohyoid neck dissection, mandibular resection, and reconstruction with recon plates were carried out. Histopathologic examination was suggestive of epithelioid variant of SC which was contrary to the incisional biopsy report. The dilemma in diagnosis was resolved by observing the presence of invading atypical epithelial cells into the stroma confirming the epithelial origin of the tumor.

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Ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation: a case report

BMC Surgery ◽

10.1186/s12893-021-01099-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Shangqing Ren ◽

Hualin Feng ◽

Yige Bao ◽

Yi Wei ◽

Yong Ou ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Urinary Tract ◽

Urothelial Carcinoma ◽

Cell Carcinoma ◽

Squamous Cell ◽

Standard Treatment ◽

Clinical Manifestations ◽

Sarcomatoid Carcinoma ◽

Upper Urinary Tract ◽

Malignant Tumours

Abstract Background Upper urinary tract urothelial carcinoma (UTUC) with multiple pathological types is extremely rare in the clinic, but the recurrence rate and mortality these patients are high. At present, there is no standard treatment for such cases. Case presentation We reported a case of ureteral urothelial carcinoma with squamous cell carcinoma and sarcomatoid carcinoma differentiation and rapid ileal metastasis and reviewed the literature related to different pathological types of upper urinary tract tumours to explore the diagnosis, treatment and prognosis characteristics of the disease, enhance our understanding of its clinical manifestations and history of evolution and provide guidance for avoiding missed diagnosis and misdiagnosis. Conclusion There is no standard treatment for urinary malignant tumours with multiple pathological types; radical surgery is considered a suitable choice. Chemotherapy, targeted drug therapy and immunotherapy may be beneficial to the survival of patients. In short, these patients have a high risk of recurrence and metastasis and a poor prognosis.

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