DOI: 10.11648/j.ijsrp.20260101.12 ISSN:

Recurrent Spindle Cell Carcinoma in the Region of the Cheek: A Case Report

Tooba Noor, Kashif Shahzad, Muhammad Mudassar, Samaviya Atif, Affan Mudassar, Naveera Waseem
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Spindle cell carcinoma (SpCC) is a rare and aggressive variant of squamous cell carcinoma characterized by a distinctive spindle-cell morphology and variable epithelial differentiation. It most frequently develops in the mucosal surfaces of the upper aerodigestive tract, particularly the larynx, hypopharynx, and oral cavity. Although maxillofacial involvement can occur, recurrent SpCC involving the cheek and mandibular region represents an uncommon clinical presentation and may pose significant diagnostic and therapeutic challenges. We report a case of recurrent spindle cell carcinoma involving the cheek and mandibular region following previous treatment. The patient presented with clinical features suggestive of a recurrent malignant lesion, and radiological evaluation demonstrated tumour involvement of the affected maxillofacial region. Histopathological examination revealed a highly atypical spindle-cell proliferation with malignant cytological features, raising consideration of several differential diagnoses, including spindle cell sarcoma, malignant fibrous histiocytoma, and other mesenchymal neoplasms. Given the unusual morphology and anatomical location, immunohistochemical evaluation was performed using a broad panel of epithelial and mesenchymal markers. The immunoprofile demonstrated epithelial differentiation and supported the diagnosis of spindle cell carcinoma, allowing distinction from primary mesenchymal spindle-cell malignancies. The recurrent nature of the lesion further emphasized the aggressive biological behaviour and potential for local recurrence associated with SpCC. Management of these tumours requires careful correlation of clinical, radiological, histopathological, and immunohistochemical findings, particularly when conventional squamous differentiation is inconspicuous. This case highlights the diagnostic complexity of recurrent SpCC in an uncommon cheek and mandibular location and emphasizes the importance of maintaining a high index of suspicion when evaluating recurrent spindle-cell lesions of the maxillofacial region. Early recognition, accurate pathological diagnosis, appropriate assessment of local and regional disease, and multidisciplinary management are essential for optimizing treatment and follow-up. Awareness of this rare presentation may facilitate timely diagnosis and improve clinical decision-making in patients with recurrent maxillofacial spindle cell carcinoma.

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