Partial Glossectomy Research Articles

Randomized phase III study to evaluate the value of omission of prophylactic neck dissection for stage I/II tongue cancer: Japan Clinical Oncology Group study (JCOG1601, RESPOND)

For stage I/II tongue cancer patients, it is controversial whether prophylactic neck dissection should be performed with partial glossectomy. Based on the evidence of the primary tumor's depth of invasion as a predictive factor of occult lymph node metastases and a prognostic factor of disease-free survival, randomized phase III trial was initiated in November 2017 to evaluate the omission value for prophylactic neck dissection for stage I/II tongue cancer with 3-10 mm of depth of invasion. In 5 years, 440 patients will be accrued from 28 institutions. The primary end point of the study is the overall survival, whereas the secondary end points are relapse-free survival, local relapse-free survival, proportion of unresectable relapse and of cervical lymph node relapse, post-operative function (paralysis of the accessory and facial nerves and subjective symptoms) and adverse events. This trial has been registered with the UMIN Clinical Trials Registry (registration number: UMIN000030098; http://www.umin.ac.jp/ctr/index.htm).

Case of making maxillary palatal augmentation complete denture for patient with dysphagia after partial glossectomy

Case of making maxillary palatal augmentation complete denture for patient with dysphagia after partial glossectomy

215. Squamous cell carcinoma of the tongue in pregnancy – An emerging management dilemma

Introduction Increasing incidence of head and neck squamous cell carcinoma (SCC) in females is reported. There is concern this emerging trend will see increasing numbers in pregnancy with no consensus on management. In the literature, when treatment has been limited by fetal concerns, there is a trend towards early recurrence and poor prognosis. This is usually delay in treatment or restricting extent of surgery in contrast to typical management outside of pregnancy. Case A 33-year-old woman reported an ulcer on the lateral aspect of her tongue from the first trimester. At 29 weeks a biopsy demonstrated aggressive SCC of the tongue with lymph node metastasis (T2 N1). She had a history of type-2 diabetes mellitus. She had never smoked or drunk alcohol. An urgent multidisciplinary discussion resulted in a plan for elective pre-term caesarean section to facilitate early surgery. She was delivered at 31 + 2 weeks following corticosteroids and magnesium sulphate for fetal lung maturation and neuroprotection respectively. She was transferred to a tertiary maxillofacial unit and a partial glossectomy, unilateral neck dissection and lymph node excision performed on day 4 postpartum. She made an uneventful recovery and is coping well with speech therapy. Now 9 months postpartum there is no evidence of recurrence. Her baby was discharged at 4-weeks-old and to date has no ill effects of prematurity. Discussion There is increasing understanding of the benefits of managing women with cancer in pregnancy in accordance with non-pregnant standards, avoiding under-treatment and poor prognosis. Rarely is premature delivery necessary. Head and neck SCC presents unique challenges, surgery can be complex with difficult airway management and unpredictable, long operating times. Limiting extent of surgery because of fetal concerns is reported with grave consequences. Multidisciplinary planning with patient involvement is key to make a balanced risk assessment for the mother and fetus.

Pigmented Squamous Cell Carcinoma of the Tongue: a Case Report

Squamous cell carcinoma (SCC) is the most common malignant tumor of the mouth. Several histopathologic variants of SCC have been reported, including pigmented SCC (PSCC). To the best of our knowledge, only 16 cases have been described in the literature. The objective of this study was to present a case of PSCC and discuss the differential diagnoses. A 70-year-old woman was referred for evaluation of an ulcerated and pigmented lesion on the right border of the tongue, present since 3 months prior. According to clinical features, our main diagnostic hypotheses were PSCC and melanoma. The histopathologic features were proliferation of atypical squamous cells with melanin and dendritic melanocytes without atypia, leading to the final diagnosis of PSCC. A partial glossectomy and neck dissection were performed. The patient is asymptomatic 4 months later. In conclusion, the histopathologic features were important considerations to avoid misdiagnosis of melanoma.

Functional outcomes after glossectomies: Pilot study on use of a thrombin-fibrinogen biosponge (TachoSil)

The aim of this study was to investigate whether the use of a thrombin-fibrinogen biosponge (TachoSil) has any advantage in tongue healing. A retrospective study with 30 patients treated with partial glossectomy (below half a tongue) was designed. We compared the results from a group using the biosponge (n =15 patients) and a control group (n = 15). Variables taken into consideration were bolus clearance, frenulum flexibility, and oral transit time. With these parameters, we formulated a "tongue remaining functional" (TRF) scale to assess tongue functionality after the surgery. We also evaluated long-term quality of life by using the Functional Intraoral Glasgow Scale (FIGS). In this study, TRF score, bolus clearance, oral transit time, and frenulum flexibility were significantly improved in the biosponge group. However, there were no differences between the 2 groups in the FIGS scores. The use of the biosponge in this pilot study showed positive long-term effects in lingual healing and functionality after partial glossectomies.

Gastro-omental free flap for reconstruction of tongue defects

ObjectivesThe purpose of this paper is to report the technique and outcomes of the use of gastro-omental free flap reconstruction in glossectomy defects. Materials and MethodsThis is a prospective case series of 9 patients of tongue squamous cell carcinoma, who underwent either subtotal or partial glossectomy and reconstruction with gastro–omental free flap. The flap anatomy, surgical technique and the outcomes including the swallowing and speech are presented. ResultsFive patients underwent partial glossectomy and 4 had sub-total glossectomy. The median age was 43 years; and the median follow up was 11.4 months. Laparoscopic harvest was done in 8 patients. There was one flap loss. Seven patients underwent postoperative radiotherapy. Functional evaluation was done in 5 patients who were disease free. Four could tolerate soft diet orally, one patient was on liquid to pureed diet. Speech was intelligible in 4. None of the patients had any complications related to laparotomy or laparoscopy. ConclusionGastro-omental flap provided a secretory mucosal surface and was beneficial in the saliva depleted patients post radiotherapy. The laparoscopic harvest of this flap has minimized donor site morbidity. One patient had a flap loss. Two patients reported superficial ulcerations on the surface, one of them had to undergo surgical debulking to correct it while the other healed with conservative measures. Speech and swallowing outcomes of the reconstructed tongue was good, especially in patients with partial glossectomy. The reconstructed gastric mucosal flaps tolerated the adjuvant radiation well.

Prosthetic Rehabilitation with Implant-Supported Mandibular Overdenture after Partial Glossectomy and Radiation Therapy: A Case Report.

Implant-supported overdenture is a well-established treatment option for many patients who have functional problems with conventional dentures. It may be primary choice for patients with altered jaw anatomy, neuromuscular disorders, pronounced gag reflex, severe residual ridge resorption and oral tissue defects. In this article we describe a case report, where tongue cancer patients occlusion was rehabilitated with an implantretained overdenture. In 2001 patient was operated for squamous cell carcinoma on the left side of the tongue. Before preoperative radiation therapy, small residual mandibular dentition was removed because of its poor prognosis. Radiation dose on mandible was 57-66 Gy. After tumor surgery patient received conventional complete dentures. Ten years later, the patient was referred again to the Turku University Central Hospital due to constant ulceration under the mandibular denture. The residual ridge of the mandible was severely resorbed. Patient's existing lower complete denture was replaced with a milled bar-retained overdenture on four implants. Treatment turned out to be challenging due to severely restricted tongue movement and tissue defects.

ACE Inhibitor Reaction‐Induced Acute Angioedema Leading to Macroglossia: Two Case Studie

Macroglossia, either congenital or acquired enlargement of the tongue, is a rare condition that leads to functional deficiencies in speech, mastication/deglutition, and airway patency. Acute‐acquired cases of macroglossia are potentially life threatening and have myriad etiologies. Presented here are two cases of macroglossia in adults caused by acute angioedema resulting from reaction to angiotensin‐converting enzyme (ACE) inhibitors. The mechanism of ACE inhibitor‐induced angioedema is attributed to dysfunction in the kallikrien‐kinin system, a protease pathway converting high molecular weight kininogens to kinins such as bradykinin, which can lead to inflammation of the cardiovascular system. This condition, while rare in adults, is more easily diagnosed, monitored, and treated if detected early. However, many clinicians fail to educate patients on the warning signs of acute angioedema: swelling of the tongue, submandibular and pharyngeal spaces, and/or difficulty breathing. Furthermore, patients often do not recognize the symptoms of ACE inhibitor reactions, leading to delays in diagnosis and treatment. Management of acute angioedema and subsequent macroglossia includes hospitalization and intubation for airway maintenance, partial glossectomy, and subsequent glossal rehabilitation and speech therapy. Both cases presented here led to anoxic brain injury and necessitated intensive surgical intervention, demonstrating the need for better patient‐clinician communication for positive outcomes of ACE inhibitor use. Current research on the kinin system and its role in the cardiovascular system is limited, so baseline clinician‐patient education represents the best first‐line defense against life‐threatening cases of acute angioedema.Support or Funding InformationThis research is supported in part by funding from the Texas A&M University College of Dentistry and the Baylor University Medical Center at Dallas.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Swallowing Outcomes in Elderly Patients following Microvascular Reconstruction of the Head and Neck.

Objective To describe swallowing outcomes in elderly patients undergoing microvascular reconstruction of the upper aerodigestive tract and identify risk factors for poor postoperative swallowing function. Study Design Case series with chart review. Setting Academic medical center. Subjects and Methods Sixty-six patients aged ≥70 years underwent microvascular reconstruction of the upper aerodigestive tract. The primary outcome measure was the Functional Oral Intake Scale (FOIS); preoperative and postoperative scores were dichotomized to define "good swallowing" and "poor swallowing." Logistic regression was performed to identify risk factors for poor postoperative swallowing function. Results In total, 91% of reconstructions were performed for oncologic defects. The most common defect site was the oral cavity (67%), and the anterolateral thigh (29%) was the most frequently used donor site. At 3-year follow up, 75% of patients had good swallowing function with 95% of patients who achieved good swallowing function doing so within 6 months of surgery. On multivariable analysis, patients with pT4 tumors (odds ratio [OR], 5.2; 95% confidence interval [CI], 1.0-25.6) and those undergoing at least partial glossectomy (OR, 4.7; 95% CI, 1.1-20.7) were more likely to experience poor swallowing function at 6-month follow-up. Conclusion Approximately half of elderly patients achieve good swallowing function within 6 months following microvascular reconstruction of the upper aerodigestive tract. Elderly patients with pT4 tumors and those requiring glossectomy are at highest risk for poor swallowing outcomes. These data can be used to inform preoperative patient counseling and design interventions aimed at improving swallowing function in those at high risk for poor outcomes.

Radiobiological Analysis for Osteoradionecrosis in Patients Treated With IMRT for Head and Neck Cancer: A Department of Veterans Affairs Experience

Previous publications by our group regarding osteoradionecrosis (ORN) induced by head and neck (H&N) radiation therapy (RT) have focused on the total physical dose deposited at the lesion site within the mandible. Furthermore, there seems to be a volume effect predicting increasing chance of ORN with a larger proportion of mandible receiving higher total dose. As with most published results, a relatively scarce number of cases limits the validity of findings, and biological consequence of spatial variation of dose per fraction is often ignored. In this study, we have pooled cases of ORN from two Veteran Affairs (VA) radiation oncology facilities, and analyze the pattern of failure based on the concept of biologically effective dose (BED). Ten patients treated with H&N radiation therapy were identified to have ORN (median time from RT completion to diagnosis of ORN was 6 months; range: 3.2 to 52.8 months). All were male veterans, with median age of 63.5 when receiving initial treatment. Five had primary oropharyngeal cancer, 3 had oral cavity cancer, and 2 were treated for unknown H&N primary. All ORN sites were localized toward the posterior portion of the mandible or retromolar area. Concurrent platinum-based chemotherapy was given to 5 patients and Cetuximab to 3. One had salvage mandibulectomy before developing ORN, the other had partial glossectomy before being treated with hypofractionated RT along with Cetuximab. Dosimetric outcomes were analyzed retroactively for 8 cases with available detailed treatment plans, using BED and linear-quadratic equivalent dose based on 2-Gy per fraction (LQED2). The average LQED2 based on the prescribed fractionation scheme was 69.3±1.4 Gy (BED of 115.6±2.4 Gy3). At the ORN lesion site, the average LQED2 was 76.0±4.1 Gy (BED of 126.7±6.8 Gy3), representing a 9.7% increase over the prescribed dose. For the entire mandible (average total volume of 74.0±14.5 cc), the average percent volumes receiving minimal LQED2 of 70 (V70) Gy (corresponding to BED of 116.7 Gy3) was 12.4±15.5%, corresponding to an absolute mandibular volume of 8.3±10.1 cc. Thus, while the mandible might be considered as a serial organ as far as ORN is concerned, it might be associated with a moderate volume effect. ORN can result from increased LQED2 or BED which may not be conspicuous from a dosimetric plan based solely on physical dose display. This study demonstrates the utilization of radiobiologically sound dosimetry which clinicians can use to quantify risk of late complications due to the “double trouble” arising from altered fractionation schemes. For the mandible, DVH guidelines based on BED or LQED2 might be better representations to predict true incidence of ORN, and useful when constructing the dose-response relation as a normal-tissue complication probability (NTCP) curve.

Outcomes of Stage I-II Squamous Cell Carcinoma of the Oral Tongue Managed With Surgery Including an Elective Nodal Dissection: Potential Indications for Postoperative Radiation Therapy

Patients with pathologic T1-2N0 oral tongue squamous cell carcinoma (OTSCC) are considered “low risk” and typically do not receive adjuvant treatment. We sought to characterize the outcomes of patients managed with surgery alone, their recurrence patterns, and any prognostics factors predictive of recurrence and/or survival. We retrospectively reviewed the records of 84 consecutive patients with newly diagnosed, early-stage pT1-2N0 OTSCC who underwent partial glossectomy and ipsilateral elective neck dissection from 2007-2013 at our institution. Patients who received PORT were excluded as well as those who had positive margins, pathological nodal involvement, or a history of prior or synchronous head and neck primaries. The cohort was 60% male and was comprised of 62% pT1 and 65% grade 2-3 tumors. Of the patients, 51% were current or former smokers. Median age was 58.5 (range: 20-87 years). With a median follow-up of 58 months (range: 3-131 months), 13 (16%) patients developed a relapse. The site of first relapse was isolated local in 5 patients, isolated regional in 2 patients, and combined locoregional in 6 patients. No patients developed a distant recurrence, either isolated or combined, at the time of first relapse. Regional recurrences were ipsilateral in 75% and contralateral in 25% of patients. Overall, the 5-year rates for local control (LC), regional control (RC), locoregional control (LRC), disease-free survival (DFS), disease-specific survival (DSS), and overall survival (OS) were 89%, 91%, 86%, 80%, 93%, and 87%, respectively. Pathologic T2 status was a predictor for worse outcomes across all endpoints. Perineural invasion (PNI) was a predictor for worse RC (P=.04), DSS (P=.001), and OS (P=.001). Margin ≤2 mm was a predictor for worse LC (P=.0001) and PFS (P=.0011). Nine of the 49 (18%) patients with depth of invasion (DOI) ≥4 mm suffered locoregional relapses (LRR). Of the 5 patients with pT2 and PNI, 2 (40%) developed isolated regional relapses. Of the 24 patients with pT2 and DOI ≥4 mm, 5 (21%) had regional failures. Patients who developed neck recurrences experienced a significantly worse DSS (5-year: 38% vs 100%; P<.0001) and OS (5-year: 38% vs 92%; P<.0001) compared to those who did not. All relapses underwent further salvage treatment; 8 (62%) patients were successfully salvaged with no evidence of disease at last follow-up. At our institution, patients with early-stage, pT1-2N0 OTSCC exhibited relatively low rates of LRR and good overall prognosis. Regional relapse, however, significantly impacts OS adversely. Patients with pT2 disease who have PNI and/or DOI ≥4 mm appear to be at considerable risk of regional relapse and should be counseled regarding PORT. When feasible, wider margins >2 mm should be obtained surgically.

Surgical Outcomes of Patients with Beckwith-Wiedemann Syndrome

PurposeThe purpose of this study was to evaluate treatment and surgical outcomes of patients of Beckwith-Wiedemann Syndrome (BWS) treated at a tertiary children's hospital. MethodsA retrospective review of infants evaluated at Texas Children's Hospital for BWS from August 2000 to December 2016 was performed. Data collected included demographic information, clinical presentation, genetic evaluation, fetal imaging, operative treatment, and outcomes. ResultsForty-seven children with a diagnosis of BWS were identified. Sixty-four percent (n=30) had a genetic mutation in an imprinting domain of chromosome 11p15. Thirty-two patients (68%) underwent at least one operation related to BWS with a median of 2 [range: 0–8] surgical procedures per patient. Sixteen underwent omphalocele repair, 12 had partial glossectomies-, 7 underwent surgeries related to hemihypertrophy, and 6 had resection of an embryonal tumor (two adrenal cortical adenoma, one Wilms' tumor, two hepatoblastoma). Overall, survival was 100% with feeding difficulty (47%) being the most frequent complication. ConclusionA substantial number of patients with Beckwith-Wiedemann Syndrome will require surgery. However, overall outcomes are similar between those that require surgery and those that do not. Level of EvidenceLevel III.

National trends in tongue reduction surgery for macroglossia in children

ObjectivesTo examine the frequency of partial glossectomy performed for the indication of macroglossia in children within the United States, assessing for differences in rates of intervention across various demographics.To identify potential morbidities associated with partial glossectomy in this population and determine how such factors may influence length of stay and cost of admission following tongue reduction surgery. Study DesignRetrospective cross-sectional study. SettingThe Kids' Inpatient Database 2003, 2006, 2009, and 2012. SubjectsPatients under age 5 diagnosed with macroglossia who underwent partial glossectomy. MethodsDemographics were analyzed and cross tabulations, linear regression modeling, and multivariate analysis were performed. ResultsDuring the four-years studied, partial glossectomy was performed in 196 children under age 5 with macroglossia. A disproportionately higher rate of intervention was seen in white children (p = 0.001), patients undergoing surgery in the mid-west (p < 0.001) and patients in the highest socioeconomic quartile (p = 0.015). Most patients underwent glossectomy in their second year of life. The average length of stay in patients who underwent partial glossectomy for macroglossia was 9.59 days (Range 1–211 days, median 3.45 days) and the average cost was $56,602 (median $16,330). ConclusionPartial glossectomy for macroglossia is typically performed prior to age 2 in the United States. A higher rate of intervention is seen in white children, those who have surgery in the mid-west and affluent children even when controlling for confounding variables. Level of evidenceIII.

CRC10: Prosthetic rehabilitation of a patient with surgically acquired velopharyngeal insufficiency and partial glossectomy

CRC10: Prosthetic rehabilitation of a patient with surgically acquired velopharyngeal insufficiency and partial glossectomy

Predicting complications of major head and neck oncological surgery: an evaluation of the ACS NSQIP surgical risk calculator

BackgroundThe American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) universal surgical risk calculator is an online tool intended to improve the informed consent process and surgical decision-making. The risk calculator uses a database of information from 585 hospitals to predict a patient’s risk of developing specific postoperative outcomes.MethodsPatient records at a major Canadian tertiary care referral center between July 2015 and March 2017 were reviewed for surgical cases including one of six major head and neck oncologic surgeries: total thyroidectomy, total laryngectomy, hemiglossectomy, partial glossectomy, laryngopharyngectomy, and composite resection. Preoperative information for 107 patients was entered into the risk calculator and compared to observed postoperative outcomes. Statistical analysis of the risk calculator was completed for the entire study population, for stratification by procedure, and by utilization of microvascular reconstruction. Accuracy was assessed using the ratio of predicted to observed outcomes, Receiver Operating Characteristics (ROC), Brier score, and the Wilcoxon signed–ranked test.ResultsThe risk calculator accurately predicted the incidences for 11 of 12 outcomes for patients that did not undergo free flap reconstruction (NFF group), but was less accurate for patients that underwent free flap reconstruction (FF group). Length of stay (LOS) analysis showed similar results, with predicted and observed LOS statistically different in the overall population and FF group analyses (p = 0.001 for both), but not for the NFF group analysis (p = 0.764). All outcomes in the NFF group, when analyzed for calibration, met the threshold value (Brier scores < 0.09). Risk predictions for 8 of 12, and 10 of 12 outcomes were adequately calibrated in the FF group and the overall study population, respectively. Analyses by procedure were excellent, with the risk calculator showing adequate calibration for 7 of 8 procedural categories and adequate discrimination for all calculable categories (6 of 6).ConclusionThe NSQIP-RC demonstrated efficacy for predicting postoperative complications in head and neck oncology surgeries that do not require microvascular reconstruction. The predictive value of the metric can be improved by inclusion of several factors important for risk stratification in head and neck oncology.

Low Grade Myofibroblastic Sarcoma of the Tongue: A Case Report in an Infant

A case of a 12-month-old male infant, who presented a painless swelling of the right anterolateral edge of the mobile tongue, is reported. The treatment consisted of a partial glossectomy with total surgical excision of the tumor. The diagnosis of low grade myofibroblastic sarcoma on the histological arguments (tumor architecture, cytology, mitotic index) and immunohistochemistry was retained.

Outcomes of Drug-Induced Sleep Endoscopy-Directed Surgery for Pediatric Obstructive Sleep Apnea.

Objectives To determine the effectiveness of pediatric drug-induced sleep endoscopy (DISE)-directed surgery for children with infant obstructive sleep apnea (OSA) or OSA after adenotonsillectomy. Study Design Case series with chart review. Setting Tertiary care pediatric hospital. Subjects and Methods We included 56 children undergoing DISE from October 2013 to September 2015 who underwent subsequent surgery to address OSA. The primary outcome was successful response to DISE-directed surgery based on the postoperative obstructive Apnea-Hypopnea Index (oAHI). Wilcoxon matched-pairs signed-ranks tests were used to compare polysomnography variables before and after surgery, and regression was used to model response to surgery. Results We evaluated 56 patients with a mean age of 5.9 ± 5.5 years (range, 0.1-17.4) and mean body mass index of 21.2 ± 7.9 kg/m2 (percentile, 77 ± 30). The most commonly performed surgical procedures were adenoidectomy (48%, n = 27), supraglottoplasty (38%, n = 21), tonsillectomy (27%, n = 15), lingual tonsillectomy (13%, n = 7), nasal surgery (11%, n = 6), pharyngoplasty (7%, n = 4), and partial midline glossectomy (7%, n = 4). Mean oAHI improved from 14.9 ± 13.5 to 10.3 ± 16.2 events/hour, with 54% (30 of 56) of children with oAHI <5 and 16.1% (9 of 56) with oAHI <1. There was a significant improvement in oAHI ( P = .001) and saturation nadir ( P < .001) but not in time with end tidal carbon dioxide >50 mm Hg ( P = .14). Multivariable modeling, controlling for age, race, body mass index, sex, and baseline polysomnography variables, revealed that white race predicted success of DISE-directed surgery. Conclusion Fifty-four percent of children with infant OSA or persistent OSA after adenotonsillectomy had oAHI <5 events per hour after DISE-directed surgery. Only white race was predictive of oAHI <5 events per hour.

Using real time magnetic resonance imaging to measure changes in articulatory behavior due to partial glossectomy

Real time MRI presents an exciting new method for studying speech articulation, providing the ability to capture articulatory kinematics and coordination. The current study utilizes real time MRI to document the speech of a patient who has undergone partial glossectomy at both preoperative and postoperative time points. While previous work has studied and evaluated postoperative outcomes, the comparison of individual speakers preoperatively and postoperatively is lacking. The possibility of compensation for the pathological articulator by other articulators necessitates the ability to image multiple articulators simultaneously to observe changes in articulatory coordination. In this paper, we present a method for quantifying changes in articulatory behavior, such as compensation for pathology, between two points in time. We find no significant changes in the patient's articulatory coordination that would indicate compensation for pathology. We attribute this to the relatively high degree of speech intelligibility preserved postoperatively for this particular patient. We do observe differences in vocal tract morphology as well as changes in the variability and principle axes of movement for the tongue. The methods we present here provide a means not only for measuring individual morphological changes, but also for observing the relationship between changes in morphology and changes in articulatory behavior.

A Simple Self-Made Scale to Design Surgical Margin in Tongue Cancer: Technical Note

We report a simple and cheap self-designed scale that is a very effective instrument for partial glossectomy and tumor excision in oral cavity. This scale could be placed on the surface of the mucosa to design the adequate and accurate surgical margin with forceps. In addition, this scale can be attached on the surface of the mucosa without holding by the forceps. Its effectiveness and safety were identified for glossectomy, tumor excision in our experience. Keywords: Surgical margin, Self-made scale, Ruler, Tongue cancer, Leukoplakia, Benign tumor

Lingual alveolar soft part sarcoma in a pediatric patient: Case report and literature review

Abstract Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma that presents most commonly in the extremities of adolescents and young adults. Involvement of the head and neck is more common in younger patients. A 2-year-old found to have localized lingual ASPS and was treated successfully with partial glossectomy. We describe this rare form of sarcoma, discuss management options, review updated literature and present our patient's outcome after 5 years of close follow-up.