Mandibular sarcomatoid carcinoma: a rare neoplasia with high aggressivity and diagnostic complexity

Ayrton Galvão de Araujo Junior; Giuliano da Paz Oliveira; Antonione Santos Bezerra Pinto

doi:10.5327/2525-5711.412

Authors

Ayrton Galvão de Araujo Junior Faculdade de Ciências Humanas, Exatas e da Saúde do Piauí, Medicine Course – Parnaíba (PI), Brazil. https://orcid.org/0000-0003-0550-5019
Giuliano da Paz Oliveira Faculdade de Ciências Humanas, Exatas e da Saúde do Piauí, Medicine Course – Parnaíba (PI), Brazil. https://orcid.org/0000-0002-3141-0032
Antonione Santos Bezerra Pinto Faculdade de Ciências Humanas, Exatas e da Saúde do Piauí, Medicine Course – Parnaíba (PI), Brazil. https://orcid.org/0000-0002-6577-2816

DOI:

https://doi.org/10.5327/2525-5711.412

Keywords:

Oral Squamous Cell Carcinoma, Spindle Cell Carcinoma, Immunohistochemistry

Abstract

Sarcomatoid carcinoma of the mandible is a rare and aggressive variant of squamous cell carcinoma characterized by biphasic epithelial and mesenchymal differentiation. The clinical and radiographic similarity to chronic inflammatory or infectious processes, such as peri-implantitis and osteomyelitis, can delay diagnosis. We report on the case of a 64-year-old patient with a painful mandibular lesion initially treated as peri-implantitis. Imaging studies revealed extensive bone destruction and soft tissue infiltration. Histopathological and immunohistochemical analysis confirmed the diagnosis of sarcomatoid carcinoma, with positivity for cytokeratins, p63, vimentin, and high Ki-67 index. Despite surgical resection with reconstruction, the patient experienced early recurrence and distant metastases, evolving to death. This case highlights the importance of accurate differential diagnosis, the contribution of imaging studies and immunohistochemical profile, and the poor prognosis associated with this neoplasm.

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