PRIMARY ORAL CAVITY LYMPHOMAS (POCL). FEATURES OF 67 PATIENTS TREATED AT A SINGLE INSTITUTION IN ARGENTINA

Abstract

Introduction: POCL represents 2-8% of head and neck cancers. They are characterized by their locoregional growth, low specificity of the initial symptoms, and a predominance of aggressive histology. Objective: To describe the characteristics of 67 patients with POCL. Methods: the medical records and pathological anatomy studies of patients admitted to the Hematology and Stomatology Services between the years 1996 and 2020 were evaluated. Results: Ages: 19 to 88 years old, mean: 52; Masc. 44 and, Fem. 23. Locations: lower jaw: 45% upper jaw 27%, base of tongue 13%, hard palate 11%, floor of mouth 4%. Histology: diffuse large B-cell lymphoma (DLBCL): 52%, plasmablastic lymhoma (PBL): 24%, Follicular L 10%; PTCL NOS 7%; Burkitt 2%, NK/T-cell L: 1,5%; MALT: 1,5%. Stages: I: 66%, II: 25% IV: 9%, due to bone marrow infiltration Increased LDH was observed in 33% of patients, β-2microglobulin in 23%, and erythrocyte sedimentation in 23%. Toxic antecedents: tobacco 30% and dental prostheses in 15%. The initial symptoms were mobility and pain of the teeth, a rapidly growing painful tumor in the jugal mucosa, and torpid oral ulcers. HIV positive in 16 patients, 13 with PBL and 7 with DLBCL. Treatment: it was carried out according to the histology, the patient's PS, viral status and date of diagnosis. The following regimes were used: CHOP, R-CHOP, CVP; R-CVP, CAVPE, CNOP; DA-EPOCH. In 15 patients there are no data on the treatment carried out. 6 cases received local radiotherapy. CNS prophylaxis with systemic methotrexate or intrathecal drugs was performed according to the schedule chosen and the patient's risk factors. Responses: complete remission (CR) in 37%, partial remission (PR) in 16% of those who underwent treatment. There's no data in 22 patients due to loss of follow-up. Follow-up time ranged from 1 year to 21 years. Conclusions: In this series of patients, we observed most aggressive histology, with fast growing locoregional tumors. Dental alterations led to consultations with stomatologists, who took diagnostic biopsies. There was a predominance of males, of B lineage, with middle ages predominate. The IPI and the stage were not useful tools for the evaluation of this pathology. The association with HIV was observed in 28% of the cases, the majority were PBL (68%), with increased DLBCL histology. Favorable responses were observed, with prolonged survival in cases with less aggressive histology. Keywords: Extranodal non-Hodgkin lymphoma No conflicts of interests pertinent to the abstract.