case_images: PMC7269287_01
case_images: Spindle cell carcinoma involving the right mandibular ramus has destroyed the posterior border of the ramus, retromolar area and ramus
case_images: JOMFP-24-168-g001.jpg
case_images: PMC7269287_01_JOMFP-24-168-g001.jpg
case_images: F1
case_images: According to the computed tomography scan, a large lytic destructive lesion with a soft-tissue component was seen as the right mandibular ramus suggestive of a malignant tumor lesion or metastasis [Figure 1].
case_images: Microscopic features of the lesion, epithelial cells in the overlying oral epithelium show nuclear polymorphism and scattered hyperchromatic nuclei. Significant increased mitotic figures are noticeable (x400). (a) The transition of the epithelial cells to the mesenchymal cells is evident (x400). (b) Immunostaining of ki-67 reveals nuclear staining in more than 20% of the spindle cells (x400). (c) Spindle cells in the stroma show immunoreactivity for pan-cytokeratin. Staining of the overlying oral epithelium serves as internal control for the staining (x40) (d)
case_images: JOMFP-24-168-g002.jpg
case_images: PMC7269287_01_JOMFP-24-168-g002.jpg
case_images: F2
case_images: Based on histopathologic features and IHC studies, the diagnosis of spindle squamous cell carcinoma and osteonecrosis was suggested [Figure 2].