ORAL SQUAMOUS CELL CARCINOMA IN PATIENTS UNDER THE AGE OF 30, A LARGE CASE SERIES

Abstract

<h3>Introduction</h3> Oral squamous cell carcinoma (OSCC) is typically associated with older adults often with established relationship to tobacco and/or alcohol abuse. OSCC is rare in children and young adults without traditional risk factors. This case series encompasses an archival review of OSCC affecting patients under 30 years of age with analyses of demographics, clinical presentation, and histologic findings. Materials and Methods: An IRB approved study queried the archives of the UF Oral Pathology Biopsy Service from 19942019. All cases of OSCC affecting patients under 30 years were identified. Age, gender, location, clinical presentation, diagnosis, and grading were recorded, and slides were reviewed for diagnostic consensus. <h3>Results</h3> During this span only 30 cases (0.76%) were identified in patients under 30 years of age out of a total of 3971 OSCC cases. Males (53.33%) were affected more commonly. An age range of 8 to 30 years with a mean of 24 years was noted. Only 3 were known smokers. In descending order, the lateral tongue, ventral tongue, and maxillary gingiva were most frequently involved. A wide spectrum of clinical diagnoses were obtained most consisting of reactive lesions. A few clinicians considered dysplasia and OSCC. Symptoms including pain, burning, swelling or dysphagia were present in 65.6% of cases. The histologic grade ranged from well to poorly differentiated. Perineural invasion was noted in 28.13%. Three out of 4 cases with P16 immunostaining at the time of sign out were positive. <h3>Conclusion</h3> This study underscores the rare occurrence of OSCC in children and young adults. This may potentially lead to low clinical suspicion, misdiagnosis, and failure of prompt treatment. Further longitudinal multicenter studies with detailed medical history, treatment, and prognostic data may cast light on better understanding of the etiology of OSCC in young patients, aid prevention, and improve outcomes.