SPINDLE CELL TUMOR OF THE MAXILLA: AN ADULT-TYPE FIBROSARCOMA OR A STORIFORM UNDIFFERENTIATED PLEOMORPHIC SARCOMA?

Spindle cell tumor of the maxilla

Abstract

OBJECTIVE: Spindle cell neoplasms of the jaws include a 
heterogenous cluster that could pose diagnostic difficulty.  
CASE REPORT: A        
44-year old woman with left maxillary 
swelling had histology showing monomorphic fusiform to spindle 
cells and few mildly pleomorphic cells arranged in a vague 
herringbone, cartwheel and storiform patterns. Also seen were few 
foci of epithelioid-like cells and ‘staghorn’ pattern of vascular 
channels. Histology differentials included: Fibrosarcoma (adult 
type), 
Malignant 
Peripheral 
Nerve 
Sheet 
Tumor, 
Hemangiopericytoma, Spindle-cell type angiosarcoma, Synovial 
sarcoma, Epithelioid sarcoma and Spindle-cell Malignant 
Melanoma and storiform Undifferentiated Pleomorphic Sarcoma. 
Immunohistochemistry was done using the antibodies: CD34, 
CD45, myogenin, synaptophysin, cytokeratin AE1/AE3, desmin, 
melan-A and vimentin. Vimentin was positive (++) while all others 
were negative. The final diagnosis was strongly suggestive of intra
osseous adult-type fibrosarcoma, mostly based on morphological 
features than immunohistochemical distinction.

CONCLUSION: This case highlights one of the difficulties faced in 
the process of diagnosis by resource-limited facilities. The patient 
has not presented for any intervention (due to financial challenges) 
as at the time of this manuscript documentation and submission.