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Spindle cell carcinoma (sarcomatoid carcinoma) of the upper aerodigestive tract is a rare malignant neoplasm and can be mis-but they also occur in the sinonasal tract, oral cavity, and esophagus. The best diagnostic tool of spindle cell carcinoma is immu-nohistologic staining. Spindle cell reacts positively with cytokeratin and vimentin, but reacts negatively with desmin, smoth muscle actin, collagen Ⅳ and s-100 protein. Squamous cell carcinoma is the major malignancy that is asociated with inverted carcinoma. To our knowledge, this is the first case report of spindle cell carcinoma acompanied by inverted papilloma, and we (Korean J Otolaryngol 203 ;46 :520-3)