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The n e w e ng l a n d j o u r na l of m e dic i n e

Images in Clinical Medicine

Chana A. Sacks, M.D., Editor

Spindle-Cell Sarcoma of the Tongue

Matteo Brucoli, M.D., D.D.S. 54-year-old man presented to the oral and maxillofacial
Arnaldo Benech, M.D., D.D.S., Ph.D. clinic with a 2-month history of difficulty chewing his food. He reported
Università degli Studi del Piemonte that during the preceding 2 months, a painless brown lesion had grown
Orientale Amedeo Avogadro on his tongue in the center of a white patch that had been present for years. He
Novara, Italy had no history of smoking and did not drink alcohol. Examination of the oral
cavity revealed a well-circumscribed hard mass, measuring 8 mm by 7 mm and
surrounded by a white patch on the right side of the tongue. He had no palpable
cervical lymphadenopathy. An incisional biopsy of the lesion revealed a high-
grade, undifferentiated spindle-cell sarcoma. Spindle-cell sarcoma is a rare
connective-tissue tumor that can grow rapidly. The patient underwent surgery,
including a hemiglossectomy, and received adjuvant chemotherapy. At follow-up
1 year after the completion of chemotherapy, he had no evidence of recurrence
and reported some mild difficulty with swallowing.
DOI: 10.1056/NEJMicm1810192
Copyright © 2019 Massachusetts Medical Society.

e10 n engl j med 380;9 February 28, 2019

The New England Journal of Medicine

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