Spindle-Cell Epidermoid Carcinoma

Abstract

Introduction For several years the authors have been interested in certain peculiar tumors of the skin and mucous membranes which have been designated as spindle-cell epidermoid carcinomas. Most of these lesions have occurred in the zone including and surrounding the lip, and this particular group has been especially selected for the present study, although tumors of somewhat similar histology have been noted in other regions, namely the larynx, esophagus, lung, cervix, bladder, and urethra. We prefer not to include with them the peculiar sarcomatoid metaplasias observed in certain tumors of glandular organs, especially of the salivary glands, breast, and thyroid. These latter tumors are well known and are represented by numerous case reports in the literature. They have been variously interpreted as carcinomas with spindle-cell metaplasia, carcinosarcomas in the sense of true mixed tumors ab initio , carcinomas in which the epithelial proliferation supposedly excites a sarcomatous stromal growth. The concept of spindle-cell metaplasia in various types of epidermoid carcinoma is far from new. Such changes in structure were clearly recognized by Krompecher (1) as early as 1900. Krompecher spoke of tumors which “aus langlichen spindeligen Zellen bestehen, welche einen intensiv farbbaren Kern aufweisen, demnach dunkel gefarbt erscheinen und sofort als gewucherte Cylinderzellen des Stratum Malpighii erkannt werden konnen.” Moreover, he states that “diese spindelartigen Zellen bilden oft Strange, welche sich in den verschiedenartigsten Richtungen durchkreuzen, und so entstehen mitunter Bilder, die vollkommen einem Spindelzellensarkom gleichen” (italics ours).