Spindle cell carcinoma in the oral cavity

A 32-year-old male presented with an exophytic, pink, raw-surfaced mass over the gingiva, 4 x 4 x 3 cm in size and extending from the right upper central incisor to the first molar. A biopsy revealed a rarely occurring spindle cell carcinoma of the oral cavity. As past medical history and pathological reports bore little relation to the present illness, the patient received radical surgery and postoperative radiotherapy and chemotherapy. Even so, the local aggressiveness and early metastatic behaviour of the tumour eventually proved fatal. Spindle cell carcinoma is an uncommon tumour of uncertain histogenesis that typically arises as a biphasic polypoid tumour. Dual expression of cytokeratin and vimentin make its differential diagnosis difficult. We describe this rarely occurring tumour, with early bilateral neck, bone and lung metastases, that warrants clinical attention for correct diagnosis at an early stage.