Adjuvant chemoradiotherapy in an elderly patient with mandibular gingival spindle cell carcinoma with reference to an immunohistochemical study

Spindle cell carcinoma (SpCC) possesses a sarcomatoid component of spindle cells and a variety of squamous cell carcinoma (SCC) component, is a very rare malignant tumor on histology occurs, which is known as a highly malignant variant of SCC. We report on summary and immunohistochemical study, because we treated with adjuvant chemoradiotherapy therapy after surgery in an elderly patient with mandibular gingival SpCC. An 87-year-old woman visited a local dental clinic with a chief complaint of swelling of the right mandibular gingiva, and was referred to our department. Intraoral examination revealed a 24 mm × 13 mm, elastic-soft, exophytic mass with a smooth, glistening, easily bleeding surface. Since PET–CT and MRI showed no findings suggestive of distant metastasis, tumor resection with marginal mandibulectomy was performed in September 2010, and histopathological examination and immunohistochemical examination of the resected specimen led to a diagnosis of SpCC. After surgery, she received adjuvant chemotherapy with S-1 and 54-Gy radiotherapy. She was discharged on the 132nd postoperative day, but 155 days after hospital transfer, she died from a poor general condition due to aspiration pneumonia. A definitive diagnosis of SpCC requires histopathological examination by H-E staining and immunohistochemical examination.