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The Laryngoscope Nov 2021Occult lymph metastasis is an important prognosticator for the treatment of early oral tongue squamous cell carcinoma (SCC). The objective of this study was to evaluate...
OBJECTIVES/HYPOTHESIS
Occult lymph metastasis is an important prognosticator for the treatment of early oral tongue squamous cell carcinoma (SCC). The objective of this study was to evaluate the prognostic significance of tumor-infiltrating lymphocytes (TILs) in early oral tongue SCC. The combination of the TIL subtype and intermediate- or high-grade budding scores was investigated as a prognostic marker for occult neck metastases.
STUDY DESIGN
Retrospective study.
METHODS
Specimens from 62 patients with early oral tongue SCC treated with only primary surgery were analyzed by immunohistochemistry for CD4+, CD8+, FoxP3+, and CD45RO+ T cells and CD163+ macrophages. The highest number of each TIL subtype was counted in two areas of parenchyma and stroma in the tumor (Tumor) and peripheral stroma of the invasion margin.
RESULTS
Based on multivariate analysis, a high density of Tumor CD163+ macrophages served as the poorest prognostic factor for regional control (RC) and disease-free survival (DFS). Patients with both a high density of Tumor CD163+ macrophages and an intermediate- or a high-grade budding score had a poor prognosis for RC according to the log-rank test.
CONCLUSIONS
In summary, each TIL subtype may use different mechanisms during early and advanced stages of oral tongue SCC. A high density of Tumor CD163+ macrophages was determined to be a risk factor for RC and DFS as well as an additional stratification factor for RC in patients with intermediate- or high-grade budding scores. Therefore, identifying TIL subtypes in daily clinical practice can help determine a more successful and individualized therapeutic approach for early oral tongue SCC.
LEVEL OF EVIDENCE
Step 4 (Level 4) Laryngoscope, 131:2512-2518, 2021.
Topics: Adult; Aged; Aged, 80 and over; Disease-Free Survival; Female; Follow-Up Studies; Head and Neck Neoplasms; Humans; Immunohistochemistry; Kaplan-Meier Estimate; Lymph Nodes; Lymphatic Metastasis; Lymphocytes, Tumor-Infiltrating; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasm Staging; Prognosis; Retrospective Studies; Squamous Cell Carcinoma of Head and Neck; Tongue; Tongue Neoplasms; Tumor Microenvironment
PubMed: 33955550
DOI: 10.1002/lary.29589 -
Oncology Reports Jun 2020Tongue cancer is one of the most common types of cancer, but its molecular etiology and pathogenesis remain unclear. The aim of the present study was to elucidate the...
Tongue cancer is one of the most common types of cancer, but its molecular etiology and pathogenesis remain unclear. The aim of the present study was to elucidate the pathogenesis of tongue cancer and investigate novel potential diagnostic and therapeutic targets. Four matched pairs of tongue cancer and paracancerous tissues were collected for RNA sequencing (RNA‑Seq), and the differentially expressed genes were analyzed. The RNA‑Seq data of tongue cancer tissues were further analyzed using bioinformatics and reverse transcription‑quantitative PCR analysis. The sequenced reads were quantified and qualified in accordance with the analysis demands. The transcriptomes of the tongue cancer tissues and paired paracancerous tissues were analyzed, and 1,700 upregulated and 2,249 downregulated genes were identified. Gene Ontology analysis uncovered a significant enrichment in the terms associated with extracellular matrix (ECM) organization, cell adhesion and collagen catabolic processes. Kyoto Encyclopedia of Genes and Genomes analysis demonstrated that these differentially expressed genes were mainly enriched in the focal adhesion pathway, ECM‑receptor interaction pathway, phosphoinositide 3‑kinase (PI3K)‑Akt pathway, and cell adhesion molecules. Comprehensive analyses of the gene tree and pathway network revealed that the majority of cell cycle genes were upregulated, while the majority of the genes associated with intracellular response, cell adhesion and cell differentiation were downregulated. The ECM‑receptor interaction, focal adhesion kinase (FAK) and PI3K‑Akt pathways were closely associated with one another and held key positions in differential signaling pathways. The ECM‑receptor, FAK and PI3K‑Akt signaling pathways were found to synergistically promote tongue cancer occurrence and progression, and may serve as potential diagnostic and therapeutic targets for this type of cancer.
Topics: Aged; Female; Gene Expression Profiling; Gene Expression Regulation, Neoplastic; Gene Regulatory Networks; High-Throughput Nucleotide Sequencing; Humans; Male; Middle Aged; Molecular Sequence Annotation; Neoplasm Staging; Sequence Analysis, RNA; Tongue Neoplasms
PubMed: 32236620
DOI: 10.3892/or.2020.7560 -
Head and Neck Pathology Sep 2020Schwannomas commonly occur in the head and neck but infrequently involve the oral cavity and rarely affect the tongue. The clinical and pathologic features of 19 cases...
Schwannomas commonly occur in the head and neck but infrequently involve the oral cavity and rarely affect the tongue. The clinical and pathologic features of 19 cases of schwannoma arising in the tongue were analyzed. There were 13 males and 6 females ranging in age from 12 to 82 years (mean 34 years; median 29 years). The majority of tumors presented as an asymptomatic mass localized to the anterior two-thirds of the tongue. Histologically, 18 schwannomas exhibited characteristic Antoni A and B areas with the former pattern predominating. One tumor was composed exclusively of cellular Antoni A tissue and was classified as a cellular schwannoma. Tumor encapsulation was variable with nearly half of the lesions lacking a well-defined fibrous capsule. All were strongly and diffusely positive for S-100 protein. No recurrences were observed on clinical follow-up. Schwannoma of the tongue, although rare, should be separated from other types of lingual nerve sheath proliferations and tumors.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Female; Humans; Male; Middle Aged; Neurilemmoma; Tongue Neoplasms; Young Adult
PubMed: 31485983
DOI: 10.1007/s12105-019-01071-9 -
Cancer Research and Treatment Jul 2017Previous studies reported an association between an increased risk of tongue cancer and radiation treatment for nasopharyngeal carcinoma (NPC). This study compared the...
Clinicopathologic Characteristics and Prognosis of Tongue Squamous Cell Carcinoma in Patients with and without a History of Radiation for Nasopharyngeal Carcinoma: A Matched Case-Control Study.
PURPOSE
Previous studies reported an association between an increased risk of tongue cancer and radiation treatment for nasopharyngeal carcinoma (NPC). This study compared the clinicopathologic characteristics and outcomes of tongue squamous cell carcinoma (TSCC) in patients with and without a history of radiotherapy for NPC.
MATERIALS AND METHODS
From 1965 to 2009, a total of 73 patients were diagnosed with TSCC with a history of radiotherapy for NPC. The patients were matched in a 1:3 ratio with patients with sporadic TSCC according to age, sex, and year of the TSCC diagnosis. The primary endpoint was the overall survival.
RESULTS
The median interval from NPC to TSCC was 82 months. The NPC survivors were more likely to be diagnosed with a more advanced T classification, less likely to have lymph node involvement, and more likely to have the tumor located in the dorsum of the tongue than sporadic TSCC. Regarding the histologic characteristics, the NPC survivors were more likely to have a weak lymphocytic host response, low tumor budding, and low risk of a worse pattern of invasion. The sporadic TSCC patients had a better overall survival (hazard ratio, 0.690; p=0.033) than the NPC survivors. In competing risks analysis, the cumulative incidence functions for the competing event (documented non-tongue cancer death) were significantly higher in the NPC survivors (Gray's test, p=0.001).
CONCLUSION
TSCC patients with a history of radiotherapy for NPC appear to have particular clinicopathologic features, a poorer survival, and are more likely to die from non-tongue cancer causes than those with sporadic TSCC.
Topics: Adult; Aged; Carcinoma; Carcinoma, Squamous Cell; Case-Control Studies; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Lymphatic Metastasis; Male; Middle Aged; Morbidity; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Neoplasm Grading; Neoplasm Staging; Neoplasms, Second Primary; Prognosis; Radiography; Tongue Neoplasms; Young Adult
PubMed: 27737535
DOI: 10.4143/crt.2016.317 -
ORL; Journal For Oto-rhino-laryngology... 2019Surgery is still the preferred treatment for tongue cancer. Reconstruction should be performed immediately after extensive resection of the tumor. The purpose of this... (Comparative Study)
Comparative Study
BACKGROUND
Surgery is still the preferred treatment for tongue cancer. Reconstruction should be performed immediately after extensive resection of the tumor. The purpose of this study was to investigate the clinical effect, advantages, and disadvantages of radial forearm free (RFF) flap and anterolateral thigh (ALT) flap in tongue reconstruction after radical resection of tongue cancer.
METHODS
Thirty-nine cases of tongue reconstruction with RFF flap or ALT flap from 2014 to 2018 were analyzed. The survival of the flap, the functional status after repair, and the influence on the donor area were examined, in addition to the advantages and disadvantages of the flap and the critical points of the technique.
RESULTS
Twenty-one cases with RFF flaps and 18 cases with ALT flaps showed complete flap survival. Among them, 1 case involved a venous vessel crisis after an ALT operation, and the flap survived after reoperation after thrombus removal and anastomosis. The recovery of tongue function was as follows: 41.0% patients exhibited normal speech, 43.6% patients exhibited near-normal speech, 12.8% patients exhibited vague speech, and 2.6% patients could not speak. There was no significant difference between the 2 groups (p = 0.134). The recovery of tongue flexibility was as follows: 41.0% of the patients had normal postoperative tongue flexibility, 43.6% of the patients had slightly limited tongue flexibility, 12.8% of the patients had severely limited tongue flexibility, and 2.6% of the patients were completely limited. The difference between the 2 groups was statistically significant (p = 0.045). The postoperative diet of patients was as follows: 51.3% of patients had a regular diet, 33.3% of patients had soft foods, 12.8% of patients received a fluid diet, and 2.6% of patients could not eat after the operation. There was no significant difference between the 2 groups (p = 0.209). The satisfaction of donor area was as follows: 46.2% of the patients were satisfied with the donor area, 51.3% of the patients were basically satisfied with the donor area satisfaction, and 2.6% of the patients were not satisfied with the donor area satisfaction. There was no significant difference between the 2 groups (p = 0.809).
CONCLUSION
The RFF flap is the most widely used technique in tongue reconstruction, especially in patients with tongue defects less than half of tongue tissue. However, for a large number of tissue defects caused by radical resection of advanced tongue cancer, the ALT flaps can provide a sufficient tissue volume, conceal scars after the operation, cause fewer complications in the donor area, and facilitate tongue function and aesthetic quality.
Topics: Adult; Aged; Female; Forearm; Free Tissue Flaps; Humans; Male; Middle Aged; Neoplasm Staging; Patient Satisfaction; Plastic Surgery Procedures; Retrospective Studies; Thigh; Tongue Neoplasms
PubMed: 31533123
DOI: 10.1159/000502151 -
International Journal of Biological... 2019Many studies have shown that FZD2 is significantly associated with tumor development and tumor metastasis. The purpose of the present study was to gain insight into the...
Many studies have shown that FZD2 is significantly associated with tumor development and tumor metastasis. The purpose of the present study was to gain insight into the role of FZD2 in the cell proliferation and invasion of tongue squamous cell carcinoma. According to TCGA-HNSC dataset, among the 10 Frizzled receptors, FZD2 exhibited the highest degree of differential expression between cancer tissues and normal tissues, and the overall survival of patients with higher FZD2 levels was shown to be significantly shorter compared with those with lower FZD2 levels. The upregulation of FZD2 in clinical tongue cancer tissues was validated by real-time PCR. Knockdown of FZD2 inhibited the proliferation, migration and invasion of CAL-27 and TCA-8113 cells, whereas overexpression of FZD2 led to the opposite results. Further analysis revealed that FZD2 is positively correlated with WNT3A, WNT5B, WNT7A and WNT2 and is negatively correlated with WNT4. These results indicated that FZD2 may act as an oncogene in tongue squamous cell carcinoma. Therefore, FZD2 may be a target for the diagnosis, prognosis and gene therapy of tongue cancer.
Topics: Carcinoma, Squamous Cell; Cell Movement; Cell Proliferation; Female; Frizzled Receptors; Humans; Male; Middle Aged; Neoplasm Invasiveness; Squamous Cell Carcinoma of Head and Neck; Tongue Neoplasms; Wnt Proteins
PubMed: 31595151
DOI: 10.7150/ijbs.33881 -
Journal of Cancer Research and... 2006Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma...
Schwannomas or neurilemmomas are benign, slow growing, usually solitary and encapsulated tumor, originating from Schwann cells of the nerve sheath. Intraoral schwannoma accounts for 1% of head and neck region and are commonly seen at the base region of tongue. Most of the few such reports in the literature, have described schwannomas that occurred in the tongue. In this article, we report a rare case of lingual schwannoma involving the anterior of tongue, in a young individual, in whom the lesion was completely excised via an intra oral approach.
Topics: Child; Humans; Immunohistochemistry; Male; Neurilemmoma; Oral Surgical Procedures; Tongue Neoplasms
PubMed: 17998681
DOI: 10.4103/0973-1482.25856 -
Oncotarget Mar 2017Due to the high frequency of loco-regional recurrences, which could be explained by changes in the field surrounding the tumor, patients with squamous cell carcinoma of... (Comparative Study)
Comparative Study
Due to the high frequency of loco-regional recurrences, which could be explained by changes in the field surrounding the tumor, patients with squamous cell carcinoma of head and neck show poor survival. Here we identified a total of 554 genes as dysregulated in clinically tumor free tongue tissue in patients with tongue tumors when compared to healthy control tongue tissue. Among the top dysregulated genes when comparing control and tumor free tissue were those involved in apoptosis (CIDEC, MUC1, ZBTB16, PRNP, ECT2), immune response (IFI27) and differentiation (KRT36). Data suggest that these are important findings which can aid in earlier diagnosis of tumor development, a relapse or a novel squamous cell carcinoma of the tongue, in the absence of histological signs of a tumor.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Carcinoma, Squamous Cell; Case-Control Studies; Female; Follow-Up Studies; Gene Expression Profiling; Humans; Male; Middle Aged; Neoplasm Staging; Prognosis; Survival Rate; Tongue; Tongue Neoplasms
PubMed: 28038473
DOI: 10.18632/oncotarget.14288 -
Head and Neck Pathology Mar 2022Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC) that is characterized by minimal cytologic atypia and a unique deeply infiltrative growth... (Review)
Review
Carcinoma cuniculatum (CC) is a rare variant of squamous cell carcinoma (SCC) that is characterized by minimal cytologic atypia and a unique deeply infiltrative growth pattern resembling rabbit burrows (cuniculi). With less than 75 cases reported in the head and neck, the clinical and pathologic spectrum of this entity remains poorly understood. A retrospective review of the clinical and pathologic features of archival cases of oral CC was performed. A total of six cases of oral CC were identified. Age ranged from 25-77 years; the male-to-female ratio was 5:1. All patients had a long-standing history of tobacco and betel-quid consumption. The tumors were distributed in the gingivobuccal sulcus (n = 2), the tongue (n = 2), buccal mucosa (n = 1), and the palate (n = 1). Histology in all cases typically revealed a tumor composed of well-differentiated squamous epithelium, devoid of atypia, lining deeply infiltrative, large-sized, branching, keratin-filled cavities, resembling rabbit-burrows. Dense lymphocytic infiltrates and discharging micro-abscesses were regular features. Underlying bone invasion and lymph node metastasis were observed in 1 patient. One patient with a tongue tumor developed locoregional recurrence at 10 months while none developed distant metastasis. Oral CC is a rare and under-recognized variant of SCC with locally aggressive behavior. Lack of familiarity with this variant exacerbated by the absence of cytologic anaplasia makes CC susceptible to multiple negative biopsies and erroneous diagnoses. Awareness of this clinicopathologic entity is essential to allow its accurate diagnosis and optimal management.
Topics: Animals; Bone Neoplasms; Carcinoma, Squamous Cell; Carcinoma, Verrucous; Female; Humans; Male; Mouth Neoplasms; Neoplasm Recurrence, Local; Rabbits; Tongue Neoplasms
PubMed: 34076846
DOI: 10.1007/s12105-021-01340-6 -
Diagnostic Pathology Feb 2022The incidence of tongue cancer in young adults is on the rise. This trend is more pronounced in females. Although the aetiology is still unclear, there is mounting...
BACKGROUND
The incidence of tongue cancer in young adults is on the rise. This trend is more pronounced in females. Although the aetiology is still unclear, there is mounting evidence that genetic syndromes can play a key role in development of oral cancers in this patient group. We report the first case of oral squamous cell carcinoma (oSCC) in a young adult with an MYH9-related disorder (MYH9-RD).
CASE PRESENTATION
A 19-year-old female with a germline MYH9 variant (missense variant in exon 2: c.287C > T, (p.Ser96Leu)) was referred to the head and neck surgery department for investigation of a painful, thick right tongue ulcer. She was diagnosed with Epstein syndrome, an MYH9-RD, at 12 years of age. Her main phenotypic features were profound thrombocytopenia and marked renal impairment. The tongue biopsy confirmed SCC. Preoperative positron emission tomography (PET) revealed avidity in the right tongue and ipsilateral level 2A neck lymph node. With substantial preoperative multidisciplinary input, she underwent cancer ablation and microvascular free flap reconstruction. Her pathology showed a 35 mm diameter, 14 mm thick moderately differentiated SCC with perineural and lymphovascular invasion. Two out of 38 right neck nodes were positive for metastasis with extranodal extension. None of the 34 left neck nodes was involved. She had an uneventful recovery and was discharged home on day 6 postoperative day. On day 15 postoperative day, she had catastrophic bleeding in the neck with a respiratory arrest after a forceful cough. She required an emergency tracheostomy and returned to the theatre for haemostasis. Following a short inpatient stay, she was again discharged home and underwent adjuvant therapy consisting of external beam radiotherapy of 60Gy in 30 fractions. On clinical examination and PET at 6 months after surgery, she had no evidence of disease recurrence.
CONCLUSIONS
MYH9-RD can present with advanced locoregional oral cavity malignancy at an early age. The combination of profound thrombocytopenia and marked renal impairment can impact heavily on routine major head and neck cancer surgery and adjuvant treatment. This rare and challenging condition underlines the importance of early detection of cancer and multidisciplinary team input.
Topics: Adult; Carcinoma, Squamous Cell; Epithelial Cells; Female; Humans; Mouth Neoplasms; Mutation; Myosin Heavy Chains; Neck Dissection; Neoplasm Recurrence, Local; Neoplasm Staging; Tongue; Tongue Neoplasms; Young Adult
PubMed: 35125114
DOI: 10.1186/s13000-022-01210-x