Case Report: Rapid recurrence and nodal metastasis of laryngeal spindle cell squamous cell carcinoma initially underestimated on superficial sampling
Abstract
Spindle cell squamous cell carcinoma (SpSCC) is an uncommon and aggressive subtype of squamous cell carcinoma. These tumors are often polypoid, and superficial biopsy or frozen section may sample only the squamous cap. A 71-year-old woman presented with a polypoid glottic lesion involving the anterior commissure and both vocal cords, with normal cord mobility, staged cT1bN0M0. Transoral CO2 laser excision was performed. Permanent sections showed moderately differentiated squamous cell carcinoma with no spindle cell component, and adjuvant treatment was not indicated. Laryngoscopy at 3 months showed no evidence of recurrence. Eight months after surgery she presented with dyspnea and cervical adenopathy. Salvage total laryngectomy with bilateral neck dissection showed SpSCC with metastases in 3 of 9 lymph nodes. Re-cutting and restaining the original paraffin block identified no spindle cell component. She declined adjuvant treatment, developed a further recurrence 6 months later, and died 12 months after the salvage operation. Because no spindle cell population was demonstrable in the first specimen, the case cannot distinguish a component that never reached the slide from one that developed in the recurrent tumor, and without clonality data neither can be excluded. That ambiguity is the substance of the report, since both readings carry the same warning. A diagnosis of conventional squamous cell carcinoma made on a small, superficial, or thermally altered specimen from a polypoid glottic lesion describes the tissue examined rather than the behavior of the tumor, and follow-up should not rest on laryngoscopy alone.
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BibTeX
@article{huang2026case,
title = {{Case Report: Rapid recurrence and nodal metastasis of laryngeal spindle cell squamous cell carcinoma initially underestimated on superficial sampling}},
author = {Yulan Huang and Xiaozou Luo and Yu Guo and Lunzhi Wang and Kai Zhang},
journal = {Frontiers in Oncology},
year = {2026},
month = nov,
doi = {10.3389/fonc.2026.1979498},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1979498},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Case Report: Rapid recurrence and nodal metastasis of laryngeal spindle cell squamous cell carcinoma initially underestimated on superficial sampling
AU - Yulan Huang
AU - Xiaozou Luo
AU - Yu Guo
AU - Lunzhi Wang
AU - Kai Zhang
PY - 2026
DA - 2026/11/04
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1979498
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1979498
AB - Spindle cell squamous cell carcinoma (SpSCC) is an uncommon and aggressive subtype of squamous cell carcinoma. These tumors are often polypoid, and superficial biopsy or frozen section may sample only the squamous cap. A 71-year-old woman presented with a polypoid glottic lesion involving the anterior commissure and both vocal cords, with normal cord mobility, staged cT1bN0M0. Transoral CO2 laser excision was performed. Permanent sections showed moderately differentiated squamous cell carcinoma with no spindle cell component, and adjuvant treatment was not indicated. Laryngoscopy at 3 months showed no evidence of recurrence. Eight months after surgery she presented with dyspnea and cervical adenopathy. Salvage total laryngectomy with bilateral neck dissection showed SpSCC with metastases in 3 of 9 lymph nodes. Re-cutting and restaining the original paraffin block identified no spindle cell component. She declined adjuvant treatment, developed a further recurrence 6 months later, and died 12 months after the salvage operation. Because no spindle cell population was demonstrable in the first specimen, the case cannot distinguish a component that never reached the slide from one that developed in the recurrent tumor, and without clonality data neither can be excluded. That ambiguity is the substance of the report, since both readings carry the same warning. A diagnosis of conventional squamous cell carcinoma made on a small, superficial, or thermally altered specimen from a polypoid glottic lesion describes the tissue examined rather than the behavior of the tumor, and follow-up should not rest on laryngoscopy alone.
SN - 2234-943X
ER -