{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T17:14:56Z","timestamp":1793812496229,"version":"4.6.1"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T00:00:00Z","timestamp":1615766400000},"content-version":"vor","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Head and Neck Pathol"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Upper aerodigestive tract (UADT) spindle cell squamous carcinoma (SCSC), also known as sarcomatoid carcinoma, is a high-grade subtype of conventional squamous cell carcinoma (SCC) that is histologically characterized by a combination of differentiated SCC in the form of intraepithelial dysplasia and\/or invasive differentiated SCC, and the presence of an invasive (submucosal) undifferentiated malignant spindle-shaped and pleomorphic (epithelioid) cell component. Typically, SCSC presents as a superficial polypoid mass not infrequently with surface ulceration precluding identification of an intraepithelial dysplasia. Further, in many cases an invasive differentiated SCC is not identified. Adding to the complexity in such cases, is that immunohistochemical staining in a significant minority of cases is negative for epithelial-related markers but often the cells express mesenchymal-related markers. In such cases, differentiating SCSC from a reactive (benign) spindle cell proliferation or a mucosal-based sarcoma can be problematic, with treatment implications. Herein, we detail the clinical and pathologic features of laryngeal SCSC and discuss the rationale for diagnosing a carcinoma and avoiding a diagnosis of sarcoma. In our experience, such cases represent one of the more common mistakes made in laryngeal pathology. Yet, virtually all such lesions are SCSCs. The treatment and prognosis relies on the accuracy of this distinction.<\/jats:p>","DOI":"10.1007\/s12105-020-01273-6","type":"journal-article","created":{"date-parts":[[2021,3,15]],"date-time":"2021-03-15T15:03:04Z","timestamp":1615820584000},"page":"130-137","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["The Most Common Mistake in Laryngeal Pathology and How to Avoid it"],"prefix":"10.1007","volume":"15","author":[{"given":"Amin","family":"Heidarian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0573-3727","authenticated-orcid":false,"given":"Bruce M.","family":"Wenig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,3,15]]},"reference":[{"issue":"s1","key":"1273_CR1","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1038\/modpathol.2016.207","volume":"30","author":"BM Wenig","year":"2017","unstructured":"Wenig BM. Squamous cell carcinoma of the upper aerodigestive tract: dysplasia and select variants. Mod Pathol. 2017;30(s1):112\u20138.","journal-title":"Mod Pathol"},{"key":"1273_CR2","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1097\/00000478-200202000-00002","volume":"26","author":"LDR Thompson","year":"2002","unstructured":"Thompson LDR, Wieneck JA, Miettinen M, Heffner SK. Spindle cell (sarcomatoid) carcinoma of the larynx: a clinicopathoogic study of 187 cases. Am J Surg Pathol. 2002;26:153\u201370.","journal-title":"Am J Surg Pathol"},{"issue":"8","key":"1273_CR3","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1097\/00000478-200208000-00007","volume":"26","author":"MA Ansari-Lari","year":"2002","unstructured":"Ansari-Lari MA, Hoque MO, Califano J, Westra WH. Immunohistochemical p53 expression patterns in sarcomatoid carcinomas of the upper respiratory tract. Am J Surg Pathol. 2002;26(8):1024\u201331.","journal-title":"Am J Surg Pathol"},{"issue":"6","key":"1273_CR4","doi-asserted-by":"publisher","first-page":"664","DOI":"10.1016\/S0046-8177(97)90175-1","volume":"28","author":"JE Lewis","year":"1997","unstructured":"Lewis JE, Olsen KD, Sebo TJ. Spindle cell carcinoma of the larynx: review of 26 cases including DNA content and immunohistochemistry. Hum Pathol. 1997;28(6):664\u201373.","journal-title":"Hum Pathol"},{"issue":"2","key":"1273_CR5","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/PAS.0000000000000119","volume":"38","author":"JA Bishop","year":"2014","unstructured":"Bishop JA, Montgomery EA, Westra WH. Use of p40 and p63 immunohistochemistry and human papillomavirus testing as ancillary tools for the recognition of head and neck sarcomatoid carcinoma and its distinction from benign and malignant mesenchymal processes. Am J Surg Pathol. 2014;38(2):257\u201364.","journal-title":"Am J Surg Pathol"},{"issue":"3","key":"1273_CR6","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s12105-012-0402-3","volume":"7","author":"S Roy","year":"2013","unstructured":"Roy S, Purgina B, Seethala RR. Spindle cell carcinoma of the larynx with rhabdomyoblastic heterologous element: a rare form of divergent differentiation. Head Neck Pathol. 2013;7(3):263\u20137.","journal-title":"Head Neck Pathol"},{"key":"1273_CR7","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s12105-008-0055-4","volume":"2","author":"JS Lewis","year":"2008","unstructured":"Lewis JS. Spindle cell lesions\u2014neoplastic or non-neoplastic? spindle cell carcinoma and other atypical spindle cell lesions of the head and neck. Head Neck Pathol. 2008;2:103\u201310.","journal-title":"Head Neck Pathol"},{"issue":"3","key":"1273_CR8","doi-asserted-by":"publisher","first-page":"250","DOI":"10.1007\/s12105-013-0438-z","volume":"7","author":"RF Watson","year":"2013","unstructured":"Watson RF, Chernock RD, Wang X, et al. Spindle cell carcinomas of the head and neck rarely harbor transcriptionally-active human papillomavirus. Head Neck Pathol. 2013;7(3):250\u20137.","journal-title":"Head Neck Pathol"},{"key":"1273_CR9","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1038\/modpathol.2008.86","volume":"21","author":"A Bahrami","year":"2008","unstructured":"Bahrami A, Gown AM, Baird GS, Hicks MJ, Folpe AL. Aberrant expression of epithelial and neuroendocrine markers in alveolar rhabdomyosarcoma: a potentially serious diagnostic pitfall. Mod Pathol. 2008;21:795\u2013806.","journal-title":"Mod Pathol"},{"key":"1273_CR10","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s12105-015-0624-2","volume":"9","author":"JA Bishop","year":"2015","unstructured":"Bishop JA, Thompson LDR, Cardesa C, et al. Rhabdomyoblastic differentiation in head and neck malignancies other than rhabdomyosarcoma. Head Neck Pathol. 2015;9:507\u201318.","journal-title":"Head Neck Pathol"},{"key":"1273_CR11","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1097\/00000478-200309000-00004","volume":"27","author":"HR Choi","year":"2003","unstructured":"Choi HR, Sturgis EM, Rosenthal DI, Luna MA, Batsakis JG, El-Naggar AK. Sarcomatoid carcinoma of the head and neck: molecular evidence for evolution and progression from conventional squamous cell carcinomas. Am J Surg Pathol. 2003;27:1216\u201320.","journal-title":"Am J Surg Pathol"},{"key":"1273_CR12","first-page":"87","volume-title":"WHO classification of head and neck tumours","author":"JA Bishop","year":"2017","unstructured":"Bishop JA, Cardesa A, Helliwell T, Hille J, Nadal A. Spindle cell squamosu cell carcinoma. In: El-Naggar A, Chan JKC, Grandis JR, Takata T, Slootweg PJ, editors. WHO classification of head and neck tumours. 4th ed. IARC Press: Lyon; 2017. p. 87\u20138.","edition":"4"},{"key":"1273_CR13","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1007\/s12105-017-0851-9","volume":"12","author":"LDR Thompson","year":"2018","unstructured":"Thompson LDR, Jo VY, Llombart-Bosch A, et al. Sinonasal tract alveolar rhabdomyosarcoma in adults: a clinicopathologic and immunophenotypic study of fifty-two cases with emphasis on epithelial immunoreactivity. Head Neck Pathol. 2018;12:181\u201392.","journal-title":"Head Neck Pathol"},{"key":"1273_CR14","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1007\/s12105-017-0876-0","volume":"12","author":"A Agaimy","year":"2018","unstructured":"Agaimy A, Semrau S, Koch M, Thompson LDR. Sinonasal leiomyosarcoma: clinicopathological analysis of nine cases with emphasis on common association with other malignancies and late distant metastasis. Head Neck Pathol. 2018;12:463\u201370.","journal-title":"Head Neck Pathol"},{"key":"1273_CR15","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1016\/j.anndiagpath.2018.09.007","volume":"37","author":"B AbdullGaffer","year":"2018","unstructured":"AbdullGaffer B, Keloth T. Laryngeal sarcomas: a case series of 5 cases. Ann Diagn Pathol. 2018;37:35\u201341.","journal-title":"Ann Diagn Pathol"},{"key":"1273_CR16","doi-asserted-by":"publisher","first-page":"859407","DOI":"10.1155\/2008\/859407","volume":"2008","author":"K Moore Dalal","year":"2008","unstructured":"Moore Dalal K, Antonescu CR, DeMatteo RP, Maks RG. EBV-associated smooth muscle neoplasms: solid tumors arising in the presence of immunosuppression and autoimmune diseases. Sarcoma. 2008;2008:859407.","journal-title":"Sarcoma"},{"key":"1273_CR17","doi-asserted-by":"publisher","first-page":"387","DOI":"10.1007\/s00428-004-0975-7","volume":"444","author":"S Boudjemaa","year":"2004","unstructured":"Boudjemaa S, Boman F, Guigonis V, Boccon-Gibod L. Brain involvement in multicentric Epstein-Barr virus-associated smooth muscle tumours in a child after kidney transplantation. Virchows Arch. 2004;444:387\u201391.","journal-title":"Virchows Arch"},{"key":"1273_CR18","doi-asserted-by":"publisher","first-page":"2217","DOI":"10.1002\/1097-0142(19951201)76:11<2217::AID-CNCR2820761107>3.0.CO;2-N","volume":"76","author":"BM Wenig","year":"1995","unstructured":"Wenig BM, Devaney K, Bisceglia M. Inflammatory myofibroblastic tumor of the larynx. A clinicopathologic study of eight cases simulating a malignant spindle cell neoplasm. Cancer. 1995;76:2217\u201329.","journal-title":"Cancer"},{"key":"1273_CR19","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1097\/PAS.0000000000000404","volume":"39","author":"CR Antonescu","year":"2015","unstructured":"Antonescu CR, Suurmeijer AJH, Zhang L, et al. Molecular characterization of inflammatory myofibroblastic tumors with frequent ALK and ROS1 fusions and rare novel RET gene rearrangement. Am J Surg Pathol. 2015;39:957\u201367.","journal-title":"Am J Surg Pathol"},{"key":"1273_CR20","doi-asserted-by":"publisher","first-page":"732","DOI":"10.1038\/modpathol.2014.165","volume":"28","author":"JL Hornick","year":"2015","unstructured":"Hornick JL, Sholl LM, Dal Cin P, et al. Expression of ROS1 predicts ROS1 gene rearrangement in inflammatory myofibroblastic tumors. Mod Pathol. 2015;28:732\u20135.","journal-title":"Mod Pathol"},{"key":"1273_CR21","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1097\/PAS.0000000000000677","volume":"40","author":"AH Alassiri","year":"2016","unstructured":"Alassiri AH, Ali RH, She Y, et al. ETV6-NTRK3 is expressed in a subset of ALK-negative inflammatory myofibroblastic tumors. Am J Surg Pathol. 2016;40:1051\u201361.","journal-title":"Am J Surg Pathol"},{"key":"1273_CR22","doi-asserted-by":"publisher","first-page":"1568","DOI":"10.1002\/1097-0142(19950401)75:7<1568::AID-CNCR2820750704>3.0.CO;2-M","volume":"75","author":"BM Wenig","year":"1995","unstructured":"Wenig BM. Laryngeal mucosal malignant melanoma. A clinicopathologic, immunohistochemical, and ultrastructural study of four patients and a review of the literature. Cancer. 1995;75:1568\u201377.","journal-title":"Cancer"}],"container-title":["Head and Neck Pathology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12105-020-01273-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s12105-020-01273-6\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s12105-020-01273-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T06:43:44Z","timestamp":1617086624000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s12105-020-01273-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3]]},"references-count":22,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["1273"],"URL":"https:\/\/doi.org\/10.1007\/s12105-020-01273-6","relation":{},"ISSN":["1936-0568"],"issn-type":[{"value":"1936-0568","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3]]},"assertion":[{"value":"30 November 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 December 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 March 2021","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with Ethical Standards"}},{"value":"All authors declare that he\/she has no conflict of interest as it relates to this.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"All procedures performed in this retrospective data analysis\ninvolving human participants were in accordance with the ethical standards of the institutional review board, which did not require informed consent.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}}]}}