Clinico- Pathological Features of Spindle Cell Carcinoma of the Oral Cavity: A Systematic Review

Introduction: Oral Spindle Cell Carcinoma (OSCC) is a rare and aggressive form of oral squamous cell carcinoma (OSCC) that is characterized by the presence of spindle-shaped wcells within the tumor. It is often difficult to diagnose due to its histological similarity with other soft tissue tumors and malignancies, leading to challenges in clinical management. The limited number of cases reported in the literature necessitates a systemic review to understand its clinical behavior, diagnosis, treatment strategies, and prognosis.

Objective: This systematic review aims to collate, analyze, and extract existing data on oral spindle cell carcinoma, with a focus on its epidemiology, pathogenesis, clinical presentation, diagnostic modalities, histopathology, and prognostic factors.

Methods: A systematic search was conducted in multiple electronic databases to identify relevant studies published. Inclusion criteria included case reports, case series, and retrospective studies that documented cases of OSCC, focusing on clinical, histopathological, and treatment-related information. A qualitative analysis was performed to extract key findings, and data were organized into thematic categories.

Results: 20 case reports were included in the review. The oldest case on Spindle cell carcinoma in oral cavity was reported in 1976 by Someren et al. All the cases were reported in different parts of the world, eight in India, one in United states, three in Japan, two in Brazil, one in China, one in Italy, one in Taiwan, one in Malasiya and one in Turkey. Three studies with cross-sectional study design were included in which data was collected retrospectively. A total of 91 participants were included. The conclusion of studies indicated that median age at onset was 51 years (range, 32–76 years). Moreover, most common site were the tongue (28%) and buccal mucosa (22%).

Immunohistochemistry is helpful to know the histogenesis and nature of SpCC. Prognosis of the disease always poor and distant metastasis is always more then the conventional SCC.

Conclusions: Oral spindle cell carcinoma is a rare and aggressive malignancy that presents diagnostic challenges due to its histological overlap with other tumors. Early detection and prompt, multimodal treatment are critical for improving outcomes. Due to the scarcity of large-scale studies, more research is needed to better understand the molecular pathogenesis, refine diagnostic criteria, and optimize treatment strategies. Regular follow-up and surveillance are essential for early detection of recurrence and metastasis, given the poor prognosis associated with advanced disease stages.