Tongue Carcinoma Research Articles

Depth of invasion（DOI） introduced in UICC 8th T classification in tongue carcinoma

Depth of invasion（DOI） introduced in UICC 8th T classification in tongue carcinoma

Paraneoplastic polyarthritis as the first manifestation of lingual carcinoma.

Paraneoplastic polyarthritis is an inflammatory arthritis, is usually seronegative, and has a temporal and pathophysiological relationship with an underlying malignancy. Although head and neck tumors may be a cause of paraneoplastic polyarthritis, its association with tongue carcinoma has not been previously reported. We present the case of a 69-year-old man who was a former smoker and presented with polyarthritis since 2 months in the wrists, proximal interphalangeal joints, knees, and elbows, with increased levels of acute-phase reactants; negativity for rheumatoid factor, anticitrullinated cyclic peptide antibody, and antinuclear antibody; and negative results for crystals and microorganisms in the synovial fluid. Cervical computed tomography and posterior rhinoscopy were performed, which detected an asymptomatic lesion on the base of the tongue, whose biopsy was compatible with nonkeratinizing squamous cell carcinoma. Polyarthritis did not respond to glucocorticoids at medium doses (oral prednisone 20 mg/day) but progressively resolved after the initiation of antineoplastic therapy.

Identification of R249 Mutation in P53 Gene in Tumoral Tissue of Tongue Cancer.

Background:Tongue cancer is the most common malignancy of the mouth. In recent decades, reported tongue cancer incidence and mortality rates have increased all over the world while survival has not improved that sometimes is related to mutation, especially in gene P53 (such R249, R248 mutations). Hence, this study aimed to identification of R249 mutation in P53 gene of tumor tissue in tongue cancer.Methods:In a cross-sectional study, 48 patients with squamous cell carcinoma (SCC) of tongue were selected, and mutation of R249 was investigated in sample of tumors. In addition, demographic data and medical history of patients were determined and registered in a collected data form. Finally added data were entered to computer and analyzed by SPSS software.Results:Polymerase-chain reaction test done on tissue samples from cancer patients showed that in a studied sample of 48 patients, 4 of them (8.3%) had R249 mutation. After selecting the codon 249 as a hotspot in oral cancer, forward and reverse primers for amplification of exon 7 were obtained from the articles.Conclusions:Considering the findings of our study, R249 mutation in P53 gene in patients with SCC is relatively high. Age and alcohol consumption were factors affecting incidence of the mutation. It is necessary to take an early treatment with a single lesion of tongue to prevent severe disease and prevent disease in patient's family with screening test and prevent cancer in future with gene therapy.

Prognostic value of immunoexpression of CCR4, CCR5, CCR7 and CXCR4 in squamous cell carcinoma of tongue and floor of the mouth.

BackgroundDiverse studies have evidenced that chemokines can play a critical role in pathogenesis of oral squamous cell carcinoma (SCC). The main chemokines involved in oral carcinogenesis, tumor invasion and metastasis are CCR4, CCR5, CCR7 and CXCR4, and our aim was to evaluate the prognostic value of the immunoexpression of these chemokines in SCC of tongue and floor of the mouth.Material and MethodsA retrospective descriptive study of the immunohistochemical expression of CCR4, CCR5, CCR7 and CXCR4 in paraffin-embedded samples of 124 patients with SCC of the tongue and floor of the mouth was performed, considering 98 cases from Brazil and 26 cases from Chile. Associations between variables were analyzed using chi-square test. Survival curves were performed using the Kaplan-Meier method and compared with long-rank test. For multivariate survival analysis, the Cox hazard model was established. The level of significance established was p≤0.05.ResultsThe statistical analysis showed that samples with well or moderate WHO model differentiation (p=0.001) and a high expression of CCR5 (p=0.05) were significantly associated with a higher disease specific survival, which were also observed in Cox´s multivariate analysis (p=0.01). A higher expression of CCR7 (p=0.01) interfered significantly in disease-free survival in univariate analysis and in Cox´s multivariate analysis (p=0.05).ConclusionsThese results support additional evidence, showing that chemokine receptors CCR5 and CCR7 are helpful as biomarkers of poor prognosis in patients with SCC of the tongue and floor of the mouth. Key words:Oral squamous cell carcinoma, prognosis, survival, chemokine receptor.

Oral squamous cell carcinoma of tongue: Histological risk assessment. A pilot study.

BackgroundMore than 90% of malignant tumors diagnosed in the oral cavity are Oral Squamous Cell Carcinomas (OSCC) whose preferred location is the tongue. Classically, this disease has affected men preferentially, although recent studies suggest that trends are changing and the proportion of women with OSCC is increasing. In addition, the prevalence of oral cancer is also determined by some risk factors as alcohol consumption and tobacco. Currently, the Tumor, Node, Metastasis (TNM) classification is employed to defined tumor stage and based on this guide specific treatments are established. However, 5-year-survival does not exceed 50% of cases. The objective of this study is to determine whether a histological risk pattern indicative of higher recurrence might be present in T1-T2 tumors located in the anterior two thirds of the tongue.Material and MethodsSamples from 26 patients with OSCC were analyzed and histological risk pattern of recurrent and non-recurrent tumors were compared. We have analyzed histological variables described in Anneroth and Brandwein-Gensler classifications. Additionally, we have also examined both clinical variables such as age, sex or comorbidities, as well as habits such as tobacco or alcohol consumption.ResultsWe found that sex (male) and keratinization degree (high or moderate) are directly related with OSCC recurrence. In fact, free illness time is lower in men and higher in those cases with minimal or no keratinization.ConclusionsBased on the variables analyzed, it has not been possible to establish a histological risk pattern that, complementary to the TNM classification, could have a predictive role in these early-stage tongue carcinomas. Key words:Oral cancer, oral squamous cell carcinoma, histologic risk assessment, oral cancer recurrence.

Squamous Cell Carcinoma Secondary to a Verrucous Carcinoma of Tongue and Redial Fore Arm Free Flap as a Reconstructive Option: A Case Report

Squamous Cell Carcinoma Secondary to a Verrucous Carcinoma of Tongue and Redial Fore Arm Free Flap as a Reconstructive Option: A Case Report

Fabrication of modified palatal augmentation prosthesis to improve functional deficits in postglossectomy and mandibulectomy patient

Squamous cell carcinoma of tongue is commonly associated with infiltration of disease into the floor of mouth and the mandible, requiring extensive ablative surgery of the tongue and the mandibular bone. This gives rise to severe facial disfigurement along with various functional deficits, such as difficulty in swallowing, mastication, and speech; uncontrolled salivary secretions; altered mandibular movements; and occlusion. This article describes the prosthetic rehabilitation of a patient who has undergone partial glossectomy with segmental mandibulectomy. It involves the fabrication of a hollow palatal augmentation prosthesis with a widened occlusal table on the nonresected side and a palatal-based guidance ramp for the mandible on the resected side. This case report presents an alternative method to rehabilitate such partially edentulous patients with compromised anatomical situation.

Radiotherapy as a primary treatment modality for squamous cell carcinoma of tongue in a case of xeroderma pigmentosum

Radiation therapy (RT) represents a important modality for treatment of malignancies in patients of xeroderma pigmentosa (XP). There are only few reports of radiation being primary treatment and thus we report a case of twelve year old female with XP presented with squamous cell carcinoma of tongue and lower lip treated with radiation at our institute. DNA damage by radiation is repaired by base excision repair, non homologous end joining and homologous combination in contrast to XP in which defect lies with nucleotide excision repair genes and therefore clinical and cellular response to RT is similar in XP as seen with other patients.

Neoneurogenesis in Squamous Cell Carcinoma of Tongue: A New Mechanism for Its Development

Objectives: To explore the role of the growth of new nerves (neo-neurogenesis) in the tumorogenesis of squamous cell carcinoma of tongue. Materials and Methods: 10 formalin-fixed specimens were gained from patients diagnosed with tongue squamous cell carcinoma. Animal models were made by subcutaneous injection in the dorsal midline with Tca-8113 cell line. Mice were sacrificed 2, 4, 6 weeks after cell injection, and tumor tissues were fixed in 4% paraformaldehyde, embedded in paraffin, sectioned. Detection of neo-neurogenesis was stained by Neurofila-ment-L antibody (NF-L) using immunohistochemistry method (IHC) in biopsy from both human body and animal model. Results: IHC staining of NF-L is positive in all 10 paraffins of tongue squamous cell carcinoma sections which suggest that newly formed nerves are observed in tumor microenvironment. NF-L staining is also positive in the paraffins from animal models indicating that the tongue cancer recruits newly formed nerves in its tumorogenesis. Conclusions: Tumor neo-neurogenesis may play an important role in the pathogenesis and development of tongue cancer. From a therapeutic perspective, further studies on the topic may provide new clinical opportunity.

Treatment of anterior floor of the mouth carcinomas

Although the floor of the mouth carcinomas are inferior as percentage as base of the tongue carcinomas, the surgical treatment should be just as radical, with large safe margins and also with neck management. Due to their anterior position, there are easier to diagnose and the patient’s presentation is also in early stages, not only in late stages. Frequently, a mandible resection is required in order to obtain safe oncologic margins. The prognosis is good, with a higher overall survival rate than in other oral malignancies.

A case of therapy-related myelodysplastic syndrome after chemoradiation for advanced tongue carcinoma

A case of therapy-related myelodysplastic syndrome after chemoradiation for advanced tongue carcinoma

Meta-analysis on risk factors of squamous cell carcinoma of the tongue in young adults

Tongue squamous cell carcinoma (TSCC) generally affects the older age group exposed to tobacco for an extended period. However, recent research points out that there is an increased incidence of TSCC in the younger age group without any traditional risk factors making TSCC as a distinct biological entity in this group. This study aims to assess the prevalence and risk factors of tongue carcinoma in the younger group of patients. This article included studies that addressed the TSCC involving young patients and that which are PubMed indexed. Initially, 390 articles were considered; but after refined evaluation, 123 articles had their titles and abstracts matching to this present work. After the extraction of the case reports, review articles and the articles without the assessment of the parameter of harmful habits, we have included only 23 articles in the sample matching the title. The statistical analysis was formed by using chi-square tests using IBM SPSS ver. 20.0. The cohort of the younger population in these studies was mostly in the 35- to the 45-year age group. The majority of reports (64%) classified the patients below 40 years of age as a young group. Though male predominance is reported to be 55%, female patients are also more affected (40%) in the younger age group compared with, the more typical and usual group of head and neck carcinoma patients. TSCC in older adults predominantly reported in tobacco users (70%) whereas in young adults, TSCC was associated with a higher incidence in nonsmokers (53%); the causes of these cancers in young adults remain unclear. The identification of the potential risk factors aside from traditional factors is vital to control the incidence of TSCC in young patients.

Radiation induced angiosarcoma of the hypopharynx: a rare case report and review of literature

Radiation-induced sarcoma in the head and neck is a long-term rare complication of radiation therapy, with an estimated risk of up to 0.3%. The incidence of these sarcomas is, however, likely to increase due to the progressive aging of the population combined with improved survival in head and neck cancer patients resulting from better treatment regimes. This is a case of post -radiation sarcoma of the hypopharynx radiated for tongue carcinoma previously. This case is reported to high light a rare but devastating complication of radiotherapy that is to be kept in mind during follow up.

A case of tongue carcinoma producing G-CFS/PTHrP appearing after recurrence

A case of tongue carcinoma producing G-CFS/PTHrP appearing after recurrence

Intraoral ultrasound to measure tumor thickness and depth of invasion in oral cancer: narrative review

Intraoral ultrasound to measure tumor thickness and depth of invasion in oral cancer: narrative review

Cutaneous metastasis of carcinoma tongue: A rare case report

Carcinoma of the oral cavity is one of the most common cancers of the head-and-neck region with frequent metastasis to internal organs, especially the lungs, liver, and bone. However, cutaneous metastasis of head-and-neck squamous cell carcinoma is rarely reported in the literature, with only a few cases reported in the past. Here, we report a case of relapse of squamous cell carcinoma of the tongue which metastasized to the upper trunk region.

Correlation between pathological tumour stage and lymph node involvement in oral cancers: a descriptive study

Background: Involvement of cervical lymph nodes is the single most important prognostic factor in oral carcinoma. This study was aimed to evaluate the correlation between tumour stage and lymph node metastasis.Methods: A descriptive study was planned in oral cancer patients who fall within the inclusion criteria. This was compared with the postoperative histopathologic status of cervical nodes. Correlation analysis was done between tumor stage and lymph node metastasis.Results: Total 106 patients were included in the study. The male female ratio was 1.4:1. Majority of the patients 37(34.9%) were in the sixth decade of life. Carcinoma of the tongue was present in 17 cases while only 4 had carcinoma of lower alveolus. Most of the patients with oral cancer presented at an early stage (T1-T2). Stage IV was the commonest with 51 (48.1%) patients. Level I was the most commonly involved lymph node station (78.1%) in squamous cell carcinoma of oral cavity. A weak significant positive correlation between tumor stage and lymph node metastases (r =0.298) was found (p = 0.002). There was a moderate significant (p = 0.0001) positive correlation (r = 0.435) between pathological tumour stage and level of lymph node involvement. But the positive correlation was not statistically significant in carcinoma of the lower alveolus (r = 0.387, p=0.112).Conclusions: Significant positive correlation between pathological tumor stage and level of lymph node involvement in oral cancer and carcinoma tongue. But, in carcinoma lower alveolus the positive correlation was not significant.

Correlation between histological grading, LVI and PNI of carcinoma oral tongue to lymph node metastasis

<p class="abstract"><strong>Background:</strong> Squamous cell carcinoma (SCC) of oral tongue has a higher predisposition to lymph node metastasis which reduces survival by 50%. In clinical practice, TNM classification is used for treatment planning which does not provide information on the biological characteristics of the tumor.</p><p class="abstract"><strong>Methods:</strong> This prospective cross sectional observational study included 30 patients with T1 to T3, N0/+ oral tongue SCC from 1<sup>st</sup> March 2014 to 30<sup>th</sup> April 2015. Incisional biopsy was taken from the primary tumour, pathological evaluation for differentiation of the tumour and assessment of lymphovascular (LVI) and perineural invasion(PNI) was carried out. Post operative histopathological examination included differentiation, LVI and PNI. The pathological findings were correlated using chi square test. </p><p class="abstract"><strong>Results:</strong> Majority presented with T2 stage. 27% had nodal metastasis. There was higher incidence of lymph node metastasis in moderately differentiated (MD) and poorly differentiated (PD) SCC which was not statistically significant. Significant correlation was seen between LVI and PNI to lymph node metastasis (p≤0.001).</p><p class="abstract"><strong>Conclusions:</strong> There is a higher incidence of lymph node metastasis seen in moderately and poorly differentiated SCC of oral tongue, which can be assessed on the preoperative biopsy, guiding us to be more aggressive in the management of cervical nodes in early tongue cancer.<strong> </strong>LVI and PNI are good predictors of nodal metastasis, help in assessing aggressiveness and prognosis of the disease, and are soft indicators for considering adjuvant / concurrent RT.</p>

Squamous cell carcinoma of the tongue in a patient with dyskeratosis congenita: a rare entity

Dyskeratosis congenita is a rare genetic disorder that results from progressive failure of the bone marrow. It presents with a classic triad of reticular pigmentations of the skin, dystrophic nails, and oral leukoplakia; patients rarely develop cancers. We report a patient with dyskeratosis congenita who presented with squamous cell carcinoma of the oral tongue.

Transoral Robotic Surgery (TORS); A More Conservative Approach to Posterior Tongue Carcinomas, and a Better Quality of Life Post-Operatively

Introduction: Transoral robotic surgery (TORS) first gained US FDA approval in 2009, for the resection of oropharyngeal cancers. It has since been used widely in this respect, and is seen as a conservative or minimally-invasive approach to head and neck surgery, while also being linked with significantly lower use of adjuvant chemoradiation1.