Spindle cell squamous carcinoma (SCSC) is a rare and peculiar biphasic malignant neoplasm that occurs mainly in the upper aerodigestive tract. It consists of sarcomatoid proliferation of pleomorphic spindle- shaped cells and squamous cell carcinoma. The diag- nosis of SCSC is often difficult to arrive at, especially when the carcinomatous component is not included in the biopsy specimen. Although the findings of histologic, ultrastructural, immunohistochemi- cal, and, more recently, molecular studies support the epithelial nature of the sarcomatoid component, this view is not yet unanimously accepted, and, as a con- sequence, there is no clear consensus as to prognosis and optimum treatment.
We report the case of a patient with SCSC involving the tongue and floor of the mouth. To gain some insight into the biology of this neoplasm, we studied proliferative activity, p53 protein expression, and DNA ploidy of the 2 different phenotypes of the tumor using immunohistochemistry and flow cyto- metric analysis.
