Spindle Cell Carcinoma
Spindle cell sarcoma can develop at any age, but it is most common in males older than 40 years.

Spindle cell carcinoma is an aggressive (rapidly developing) malignancy that has elements of both carcinoma and sarcoma. Although these tumors can develop anywhere in your body, they are typically linked to your lungs.

The difficult-to-treat spindle cell cancer spreads quickly. Surgery or clinical trials examining cutting-edge medicines are possible forms of treatment.

What is spindle cell carcinoma?

Spindle cell carcinoma is an uncommon, aggressive, sarcoma-like form of cancer. The types of tissue in your body where malignant cells (cancer cells) first originate are categorized using terms, such as “carcinoma” and “sarcoma.”

The tissue that lines your organs or skin is where cancer first develops. Because it is composed of epithelial cells, this tissue is called epithelial tissue.

The tumor starts in the soft tissue, connective tissue, and bone. Mesenchymal cells, the basic units of muscle, fat, and other tissues make up sarcomas.

Sarcoma and carcinoma cells and tissue co-occur in the tumors that develop from sarcomatoid carcinoma. These tumors spread swiftly to different places in your body and grow quickly (metastasize). As cancer grows throughout your body, it harms good tissue.

Where can you find spindle cell cancer in the body?

Your lungs are the organ most frequently linked to sarcomatoid cancer. However, cancer that resembles both sarcomas (mesenchymal tumors) and carcinoma (epithelial tumors) can develop anywhere in your body, including the following:

  • Skin
  • Bones
  • Mouth
  • Thyroid gland
  • Breasts
  • Stomach
  • Small intestine
  • Liver
  • Pancreas
  • Uterus
  • Prostate
  • Bladder
  • Kidneys
  • Mediastinum (the region around your heart, esophagus, and thymus that is situated between the lungs)

When it begins in your lungs, spindle cell carcinoma frequently spreads swiftly. The tumor may spread to the adrenal glands, brain, bone, liver, kidney, peritoneum (the lining of your abdomen and abdominal organs), pancreas, skin, and heart. Sarcomatoid carcinoma metastasis frequently involves the spread of the tumor to numerous sites.

Who is affected by spindle cell carcinoma and what is its prevalence?

The male gender and smoking tobacco products increase the chances of developing sarcomatoid cancer. The diagnostic age is 65 years on average.

  • Spindle cell sarcoma can affect people of any age, but it is most common in people older than 40 years.
  • Men are slightly more affected than women (the majority of whom have a history of smoking tobacco).

Cancer sarcomatoid is relatively uncommon. Sarcomatoid carcinomas make up only one to four percent of malignant (cancerous) lung tumors.

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What are the types of spindle cell cancer?

The WHO divided the five subtypes of sarcomatoid cancer into groups in 2015. Each variety is regarded as non-small-cell lung cancer with incomplete differentiation. When cells are poorly differentiated, their appearance makes it difficult to classify them. The most prevalent kind of lung cancer is non-small-cell lung carcinoma. It swiftly multiplies and spreads.

Five types of spindle cell cancer include:

  1. Pleomorphic carcinomas are primarily carcinomas with at least 10 percent of sarcoma components. Spindle cells, giant cells, or a combination of the two cell types may make up the components of a sarcoma. The most typical variety of sarcomatoid carcinomas is pleomorphic carcinomas. These subtypes may include:
  2. Spindle-cell carcinoma is named for the appearance of its cells under a microscope. Like a spindle, they are long and thin. Spindle-cell carcinoma exhibits traits common to both sarcomas and carcinomas.
  3. Giant cell carcinoma is made up of huge cells organized in a sarcoma-like manner. They typically develop in your upper lungs.
  4. Carcinosarcoma includes tissue from many carcinoma subtypes, such as adenocarcinoma and squamous cell carcinoma. The sarcoma's constituent parts are aberrant and malformed. They might contain tissue characteristic of sarcoma subtypes, such as:
    • Chondrosarcoma
    • Osteosarcoma
    • Rhabdomyosarcoma or angiosarcoma
  5. Pulmonary blastoma contains adenocarcinoma components that resemble fetal lung tissue. Mesenchymal cells are seen in pulmonary blastoma as well (as in sarcoma).

What are the symptoms of spindle cell carcinoma?

Your symptoms will vary depending on where the cancer has spread throughout the body.

The following are possible signs of sarcomatoid cancer in the lungs:

Why does spindle cell cancer develop?

Epithelial-mesenchymal transition (EMT), a process, is most likely the etiology of sarcomatoid cancer. The majority of sarcomatoid carcinomas begin as malignant epithelial cells similar to non-small-cell lung carcinoma. Some of these cells undergo changes that lead to their conversion to mesenchymal cells. These mutated, cancerous cells swiftly disperse throughout the body.

Rapid cell growth and alterations are probably related to genetic changes in the cells (or errors). The instructions that inform your cells how to act are encoded in your genes. A mutation is a modification or mistake that can prevent these instructions from working properly. Many different gene mutations connected to sarcomatoid cancer have been found by researchers.

What are the risk factors for spindle cell carcinoma?

A risk factor raises your chance of getting the ailment.

Risk factors for sarcomatoid cancer include:

Approximately 80 to 90 percent of people with pulmonary (lung) sarcomatoid cancer are smokers or have a history of smoking.

How is spindle cell cancer diagnosed?

A clinical assessment and imaging techniques will be carried out by your healthcare provider. They will do a biopsy to precisely examine the tumor cells to reach a conclusive diagnosis.

  • Imaging: To find the tumors, your doctor might use a CT scan. For clearer images of the inside of your body, they might perform a CT/PET scan or an F-fluorodeoxyglucose (FDG)-PET. Your doctor can do a CT scan and a PET scan simultaneously. A substance called fluorodeoxyglucose is injected into your bloodstream during a PET scan. It gathers around cancer cells, making them more visible during imaging.
  • Histopathology: In a biopsy, your doctor will take a tumor sample, which will then be carefully examined under a microscope. Histopathology is the study of tissues through analysis. A sarcomatoid carcinoma can be identified by examining the cells of a tumor. Additionally, they will categorize it into subcategories (for example, pleomorphic carcinoma, spindle-cell carcinoma, etc.)
  • Immunohistochemistry: Antigens linked to cell types are searched for via immunohistochemistry. A cell's abnormality or malignancy can be detected by specific antigens (cancerous).

How is spindle cell cancer treated?

Surgery to completely remove the tumor is the most efficient form of treatment. Following surgery, chemotherapy can help eliminate any cancer cells that remain. However, typically, when a person is diagnosed with cancer, it has already advanced and surgery is not an option. Radiation therapy could be prescribed if a tumor results in issues, such as pain, bleeding, or difficulty breathing.

The best course of action to treat sarcomatoid cancer could be a clinical trial. A clinical trial is a research project that evaluates the efficacy and safety of novel medicines. Researchers are examining targeted therapy and immunotherapy as potential therapies to help people with sarcomatoid cancer live longer.

Targeted therapy focuses on characteristics of cancer cells that drive their unchecked cell division.

Your immune system is strengthened with immunotherapy to locate and eliminate cancer cells more effectively.

Does spindle cell cancer have a cure?

There is no cure for sarcomatoid cancer. However, researchers can create therapies that specifically target the cell traits typical of malignant cancers, such as genetic abnormalities.

If you are given a sarcomatoid carcinoma diagnosis, you might be qualified for a clinical study investigating these novel therapies. Ask your doctor.

What is the sarcomatoid carcinoma survival rate?

The five-year survival rate for sarcomatoid carcinoma is about 15 percent, whereas the median survival rate is about 10 months. Your survival rate is just one of several variables that influence the likelihood of outcomes.

Several elements include:

  • The cell type
  • Which specific gene mutations are relevant
  • How long did it take for a diagnosis after you first had symptoms
  • How much healthy tissue the tumor has destroyed and developed
  • How much of the cancer has spread
  • If the tumor can be removed by your doctor
  • To get a more precise idea of your prognosis, go over these details with your healthcare professional

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Medically Reviewed on 10/27/2022
References
Image Source: iStock image

Head and neck spindle cell carcinoma: an evaluation of current management. https://europepmc.org/article/med/1281758

What Is a Soft Tissue Sarcoma? https://www.cancer.org/cancer/soft-tissue-sarcoma/about/soft-tissue-sarcoma.html

Disease-Specific Survival with Spindle Cell Carcinoma of the Head and Neck https://www.semanticscholar.org/paper/Disease-Specific-Survival-with-Spindle-Cell-of-the-Bice-Tran/a37140feae8cbe4c627b6a0fdf1c57ad3dc0a9c8