The most common metaplastic elements are spindle cell and squamous. Tumors with heterologous elements such as chondroid, osseous, and other sarcomas are less common. Metaplastic carcinomas with a prominent spindle cell component show diverse histologic patterns ranging from high-grade sarcomas to bland, fibromatosis-like lesions. The image shows a moderately cellular lesion with intermediate to high-grade nuclei. Mitotic activity is increased. Chronic inflammatory cells are scattered throughout the field. The appearance is reminiscent of a fibrosarcoma.