The Chameleon Tumor: Navigating the Diagnostic Pitfalls of Spindle Squamous Cell Carcinoma

Spindle cell squamous cell carcinoma (SCSCC) is a rare and aggressive variant of squamous cell carcinoma (SCC). It accounts for 2%-3% of all the SCC and usually arises over sun-exposed areas, prior ionizing radiation sites, or immunocompromised individuals. This uncommon subtype is characterized by the proliferation of both epithelial and mesenchymal components, making diagnosis challenging due to its histopathological resemblance to neoplastic or reactive spindle cell lesions of mesenchymal origin. SCSCC is noteworthy for its high potential for recurrence and early metastasis. immunohistochemistry (IHC) studies play a critical role in differentiating SCSCC from other spindle cell neoplasms, such as spindle cell desmoplastic melanoma, cutaneous leiomyosarcoma, and atypical fibroxanthoma. Herein, we present a rare case report of a 55-year-old male presenting with ulceroproliferative growth on buccal mucosa.