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Tongue carcinoma in an adult Down's syndrome patient: a case report.

Farhat FS, Geara F, Natout M, Serhal J, Daya W - World J Surg Oncol (2009)

Bottom Line: The over all risk is similar to that in adult population.Three months later, the patient presented with local tongue recurrence and was treated by Docetaxel and Carboplatin chemotherapy with no significant response.The patient died one month later, 9 months after his initial diagnosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hammoud Hospital University Medical Center Saida, Lebanon. drfadi@terra.net.lb

ABSTRACT

Background: Cancer of the oral cavity is rare and unusual in Down's syndrome patient. The over all risk is similar to that in adult population.

Case presentation: This case report describes a 27 years old male with Down's syndrome, non-smoker, who developed a poorly differentiated squamous cell carcinoma of the tongue. The patient underwent a hemiglossectomy without neck dissection followed by a postoperative locoregional radiation therapy to a total tumor-bed dose of 56 Gy and 45 Gy to the neck. Three months later, the patient presented with local tongue recurrence and was treated by Docetaxel and Carboplatin chemotherapy with no significant response. The patient died one month later, 9 months after his initial diagnosis.

Conclusion: To our knowledge, this is the first case of tongue carcinoma arising in a patient with Down's syndrome. This unique case might not be sufficient to make a significant conclusion on the prognosis and survival of these patients but will increase the awareness about this possibility and will help in the appropriate management of Down's syndrome patients.

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Large tumor recurrence 3 months after postoperative radiotherapy.
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Figure 3: Large tumor recurrence 3 months after postoperative radiotherapy.

Mentions: A 27 years old male with DS, non smoker and with no past medical history, presented to the otolaryngologist for hypersalivation and ulcer of his tongue. Clinical examination showed a mass of the lateral left aspect of the tongue measuring 4 × 3 cm (Figure 1) with no palpable neck lymph nodes. A biopsy was taken revealing a poorly differentiated squamous cell carcinoma. Chest X-ray, routine blood counts and chemistry were within normal range. The disease was staged T2N0M0. Two days later, the patient underwent a hemiglossectomy without neck dissection. Pathology revealed an irregular ulcerated lesion on the lateral surface of the tongue measuring 3.5 cm in maximal dimension compatible with squamous cell carcinoma infiltrating the tongue musculature with negative surgical margins. Postoperative loco-regional radiation therapy was delivered to a total tumor-bed dose of 56 Gy, and 46 Gy to the neck and there was no evidence of disease after surgery and radiotherapy (Figure 2). Three months post-radiation therapy and 7 months from the diagnosis, the patient presented with local recurrence that rapidly extended to the base of the tongue (Figure 3) and the diagnosis was confirmed by biopsy. The patient was offered radical salvage surgery that was declined by the patient and his family. The patient received 2 cycles of weekly Docetaxel (30 mg/m2) and weekly Carboplatin (area under the curve 4). Treatment was well tolerated with no nausea or neutropenia. However, evaluation at 6 weeks showed disease progression. Further chemotherapy was refused by the patient and his family. Supportive care was then initiated, along with a tracheostomy and a gastrostomy performed 2 months after the diagnosis of recurrence. The patient died one month later, 9 months after the initial diagnosis.


Tongue carcinoma in an adult Down's syndrome patient: a case report.

Farhat FS, Geara F, Natout M, Serhal J, Daya W - World J Surg Oncol (2009)

Large tumor recurrence 3 months after postoperative radiotherapy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2664806&req=5

Figure 3: Large tumor recurrence 3 months after postoperative radiotherapy.
Mentions: A 27 years old male with DS, non smoker and with no past medical history, presented to the otolaryngologist for hypersalivation and ulcer of his tongue. Clinical examination showed a mass of the lateral left aspect of the tongue measuring 4 × 3 cm (Figure 1) with no palpable neck lymph nodes. A biopsy was taken revealing a poorly differentiated squamous cell carcinoma. Chest X-ray, routine blood counts and chemistry were within normal range. The disease was staged T2N0M0. Two days later, the patient underwent a hemiglossectomy without neck dissection. Pathology revealed an irregular ulcerated lesion on the lateral surface of the tongue measuring 3.5 cm in maximal dimension compatible with squamous cell carcinoma infiltrating the tongue musculature with negative surgical margins. Postoperative loco-regional radiation therapy was delivered to a total tumor-bed dose of 56 Gy, and 46 Gy to the neck and there was no evidence of disease after surgery and radiotherapy (Figure 2). Three months post-radiation therapy and 7 months from the diagnosis, the patient presented with local recurrence that rapidly extended to the base of the tongue (Figure 3) and the diagnosis was confirmed by biopsy. The patient was offered radical salvage surgery that was declined by the patient and his family. The patient received 2 cycles of weekly Docetaxel (30 mg/m2) and weekly Carboplatin (area under the curve 4). Treatment was well tolerated with no nausea or neutropenia. However, evaluation at 6 weeks showed disease progression. Further chemotherapy was refused by the patient and his family. Supportive care was then initiated, along with a tracheostomy and a gastrostomy performed 2 months after the diagnosis of recurrence. The patient died one month later, 9 months after the initial diagnosis.

Bottom Line: The over all risk is similar to that in adult population.Three months later, the patient presented with local tongue recurrence and was treated by Docetaxel and Carboplatin chemotherapy with no significant response.The patient died one month later, 9 months after his initial diagnosis.

View Article: PubMed Central - HTML - PubMed

Affiliation: Hammoud Hospital University Medical Center Saida, Lebanon. drfadi@terra.net.lb

ABSTRACT

Background: Cancer of the oral cavity is rare and unusual in Down's syndrome patient. The over all risk is similar to that in adult population.

Case presentation: This case report describes a 27 years old male with Down's syndrome, non-smoker, who developed a poorly differentiated squamous cell carcinoma of the tongue. The patient underwent a hemiglossectomy without neck dissection followed by a postoperative locoregional radiation therapy to a total tumor-bed dose of 56 Gy and 45 Gy to the neck. Three months later, the patient presented with local tongue recurrence and was treated by Docetaxel and Carboplatin chemotherapy with no significant response. The patient died one month later, 9 months after his initial diagnosis.

Conclusion: To our knowledge, this is the first case of tongue carcinoma arising in a patient with Down's syndrome. This unique case might not be sufficient to make a significant conclusion on the prognosis and survival of these patients but will increase the awareness about this possibility and will help in the appropriate management of Down's syndrome patients.

Show MeSH
Related in: MedlinePlus