case_images: PMC6340218_01
case_images: Ulceroproliferative mass on the right posterior alveolus measuring 4 cm x 3 cm.
case_images: DRJ-16-60-g001.jpg
case_images: PMC6340218_01_DRJ-16-60-g001.jpg
case_images: F1
case_images: Intraoral examination showed a soft-tissue mass on the right posterior alveolus measuring 4 cm x 3 cm [Figure 1].
case_images: Incisional biopsy specimen from multiple sites of the lesion.
case_images: DRJ-16-60-g002.jpg
case_images: PMC6340218_01_DRJ-16-60-g002.jpg
case_images: F2
case_images: Incisional biopsy of the lesion was done [Figure 2], and immunohistochemistry was performed on paraffin-embedded tissues as per the manufacturer's protocol.
case_images: (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).
case_images: DRJ-16-60-g003.jpg
case_images: PMC6340218_01_DRJ-16-60-g003.jpg
case_images: F3
case_images: 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].
case_images: (a) Neoplastic spindle-shaped cells showing positivity for pan-cytokeratin (x100), (b and c) neoplastic spindle-shaped cells showing positivity for pan-cytokeratin (x400).
case_images: DRJ-16-60-g004.jpg
case_images: PMC6340218_01_DRJ-16-60-g004.jpg
case_images: F4
case_images: 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.