by Jason Wasserman MD PhD FRCPC
March 25, 2022
A spindle-cell neoplasm is a general term used to describe an abnormal growth (a neoplasm) made up of spindle cells (cells that are longer than they are wide). Spindle-cell neoplasm is considered a general term because it includes many different types of benign (non-cancerous) and malignant (cancerous) growths. Most malignant spindle-cell neoplasms are called sarcomas.
No. There are many types of spindle-cell neoplasms that are benign (non-cancerous). By examining the tissue under the microscope and performing additional tests, such as immunohistochemistry, fluorescence in situ hybridization (FISH), and next-generation sequencing (NGS), your pathologist will decide if the spindle cell neoplasm is benign or malignant (cancerous).
There are many different types of non-cancerous spindle-cell neoplasms. Examples include schwannoma, neurofibroma, solitary fibrous tumour, spindle-cell lipoma, leiomyoma, and fibromatosis. While all of these are non-cancerous, some (such as fibromatosis) can grow back after being surgically removed and routine follow-up with your doctor may be necessary to make sure you remain free of tumour.
Most cancerous spindle cell neoplasms are part of a large group of cancers called sarcomas. Cancers in this group can start anywhere in the body. Examples of sarcomas include malignant peripheral nerve sheath tumour, dermatofibrosarcoma protuberans, liposarcoma, osteosarcoma, leiomyosarcoma, angiosarcoma, synovial sarcoma, and undifferentiated pleomorphic sarcoma. Some other types of cancers such as squamous cell carcinoma and melanoma can also be made up entirely of spindle cells.
Pathologists often use the term spindle-cell neoplasm when describing a small tissue sample, such as a biopsy. In this instance, there may not be enough tissue available for the pathologist to make a final diagnosis and then the term spindle-cell neoplasm is used to provide a preliminary diagnosis that your doctors may use to start planning your care.