Frontiers in Oncology· 2026Q2· Case report
Case Report: Rapid recurrence and nodal metastasis of laryngeal spindle cell squamous cell carcinoma initially underestimated on superficial sampling
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- Q2SCImago
- 2026year
Short summary
A 71-year-old woman's laryngeal lesion, initially diagnosed as moderately differentiated squamous cell carcinoma via superficial biopsy, recurred rapidly with lymph node metastases eight months later, revealing an aggressive spindle cell carcinoma/carcinosarcoma upon deeper sampling and retrospective review.
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Key points
- Superficial biopsies of laryngeal lesions can underestimate aggressive spindle cell carcinoma (SpCC).
- A 71-year-old woman experienced rapid local recurrence and nodal metastasis eight months after initial diagnosis of squamous cell carcinoma.
- Deeper sampling and retrospective review identified the true diagnosis as carcinosarcoma/spindle cell carcinoma.
- Clinical or imaging findings inconsistent with superficial pathology warrant deeper sampling and closer follow-up.
AI-generated from the title and abstract; the full text is not read.
Abstract
Laryngeal spindle cell carcinoma (SpCC) is an uncommon but aggressive variant of squamous cell carcinoma. Superficial biopsy or intraoperative frozen section may sample only the epithelial component and therefore underestimate the true histology. We report a 71-year-old woman who underwent CO2 laser excision under suspension laryngoscopy for a laryngeal lesion. The initial permanent section showed moderately differentiated squamous cell carcinoma, with the stage documented as T3N0M0. Eight months later, she developed local recurrence with bilateral cervical lymph node metastases. Salvage total laryngectomy with bilateral neck dissection revealed carcinosarcoma/spindle cell carcinoma. Retrospective review of the first paraffin specimen and additional immunohistochemistry still failed to identify a definite spindle-cell component. The patient declined adjuvant therapy and died 12 months after the definitive diagnosis. This case illustrates a diagnostic trap in polypoid laryngeal lesions: when clinical or imaging findings do not match superficial pathology, deeper sampling, targeted immunohistochemistry, and closer radiologic follow-up are warranted. For advanced lesions or cases in which SpCC is suspected, initial management should prioritize oncologic safety.
The authors' abstract, as published at the source. Frontiers in Oncology, 2026 · DOI ↗
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Field: Otorhinolaryngology
OtorhinolaryngologyMedicine