Spindle cell carcinoma is a two-stage cancer with a squamous cell cancer component and spindle cell component showing sarcomatoid growth, but rarely occurs in the maxillary sinus. We report our experience with a case of spindle cell carcinoma of the maxillary sinus.
A 69-year-old male was referred to our hospital with the chief complaints of recurrent episodes of bleeding from the left nostril and swelling of the left cheek. A neoplastic lesion was found in the left nasal cavity and a biopsy was performed. However, because a definitive diagnosis could not be established, we decided to carry out surgery for verifying the diagnosis. We did not recognize any specific structure or characterristic differentiating tendency, but eventually made the diagnosis of spindle cell carcinoma based on all the findings plus the result of immunostaining. Chemotherapy with cisplatin (2 courses) and radiation therapy were conducted according to the treatment for squamous cell carcinoma, but a follow-up CT revealed no evidence of tumor reduction. Because sarcoma constituted the predominant component on histopathology, we decided to treat the patient with pazopanib, which is used for malignant soft tissue tumors, which resulted in cytoreduction. We did not find tumor enlargement for 10 months during the drug administration, but after withdrawal of the drug because of an adverse effect, the patient died of rapid worsening of pulmonary metastases.
