Spindle Cell Squamous Cell Carcinoma of the Right Vocal Cord Presenting as a Polypoid Lesion: A Rare Case Report

Abstract

Spindle cell squamous cell carcinoma (SpCC) is a rare and aggressive variant of laryngeal malignancy characterized by biphasic histology. We report a 58-year-old male presenting with progressive hoarseness for 8 months. Laryngoscopic examination revealed a polypoid lesion involving the right true vocal cord with preserved vocal cord mobility. The patient underwent complete endoscopic excisional biopsy under general anesthesia. Histopathological evaluation demonstrated conventional squamous cell carcinoma components alongside malignant spindle cells. The resection margins were free of tumor, with no evidence of lymphovascular or perineural invasion. Immunohistochemistry confirmed epithelial origin with positivity for pancytokeratin and p63, along with vimentin expression. The tumor was staged as T1aN0M0 (Stage I) according to the AJCC/UICC 8 ^th edition. Given the early-stage glottic presentation and complete tumor resection, adjuvant therapy was not pursued, and the patient was managed with close endoscopic surveillance. The patient had an uneventful postoperative recovery with preservation of voice and swallowing function. At 7 months postoperatively, the patient remained asymptomatic with no clinical or endoscopic evidence of recurrence. This case highlights the importance of early recognition, accurate diagnosis, and timely surgical intervention in early-stage glottic SpCC.