PMC6340218_01
Ulceroproliferative mass on the right posterior alveolus measuring 4 cm x 3 cm.
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F1
Intraoral examination showed a soft-tissue mass on the right posterior alveolus measuring 4 cm x 3 cm [Figure 1].
Incisional biopsy specimen from multiple sites of the lesion.
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F2
Incisional biopsy of the lesion was done [Figure 2], and immunohistochemistry was performed on paraffin-embedded tissues as per the manufacturer's protocol.
(a) Sheets of spindle-shaped cells admixed with haphazardly arranged polygonal cells (H and E, x100), (b) Polygonal and spindle cells showing pleomorphism, high mitotic activity, and atypia (H and E, x400).
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F3
Connective tissue stroma showed spindle-shaped and polygonal cells arranged in haphazard sheets showing pleomorphism, high mitotic activity, and atypia suggestive of malignancy [Figure 3a and b].
(a) Neoplastic spindle-shaped cells showing positivity for pan-cytokeratin (x100), (b and c) neoplastic spindle-shaped cells showing positivity for pan-cytokeratin (x400).
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F4
Immunohistochemistry showed positivity for pan-cytokeratin in the spindle-shaped cells [Figure 4a-c], and thus, considering the clinical history and immunohistochemical finding, a final diagnosis of spindle cell variant of SCC was made.