Lesion of Dual Nature - Carcinoma or Sarcoma: A Histopathologic Dilemma

Sarcomatoid carcinomas are biphasic tumors proven to be monoclonal dedifferentiated forms of conventional squamous carcinomas. It is a variant of squamous cell carcinoma (SCC) which has spindled tumor cells, which simulate a true sarcoma, but are epithelial in origin. They are extremely uncommon in the head and neck region. Only 10 cases have been discussed in the literature. When compared to SCC of maxilla, this variant is associated with poor diagnosis and advanced disease at presentation as is demonstrated in the case presented. Diagnosis of sarcomatoid squamous carcinoma is challenging because of overlapping histopathological features with other spindle-cell tumors. Understanding their clinicopathologic characteristics facilitates their diagnosis and appropriate clinical management. Surgery and radiotherapy form the mainstays of treatment. We report a rare case of spindle-cell carcinoma involving the mandible.