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Katz J, Saleh W, Alharbi H, Farhadfar N. Multiple oral squamous cell carcinoma 6 years after allogeneic stem cell transplantation complicated with chronic graft-versus-host disease: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221118203. [PMID: 36003891 PMCID: PMC9393490 DOI: 10.1177/2050313x221118203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022] Open
Abstract
Oral squamous cell carcinoma is a potential long-term complication after hematopoietic stem cell transplantation. This may be related to mechanisms including radiation and chemotherapy regimens, chronic graft-versus-host disease, inflammation, and prolonged immunosuppression. The current case describes the development of multiple oral white thick keratotic lesions in the floor of the mouth and the tongue 6 years after hematopoietic stem cell transplantation complicated with chronic graft-versus-host disease. A biopsy performed with histopathological analysis revealed a well-differentiated squamous cell carcinoma. The patient was treated by subtotal glossectomy, bilateral neck dissection, and flap reconstruction. This report highlights the significance of the routine oral examination of long-term surveillance post hematopoietic stem cell transplantation to ensure early detection of these tumors at potentially treatable stage.
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Affiliation(s)
- Joseph Katz
- Oral Diagnostic Sciences Department, College of Dentistry, University of Florida, Gainesville, FL, USA
| | - Wafaa Saleh
- Oral Medicine and Periodontology Department, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
| | - Hamad Alharbi
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Nosha Farhadfar
- Division of Hematology & Oncology, College of Medicine, University of Florida, Gainesville, FL, USA
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Two Lip Carcinomas following Allogeneic Hematopoietic Stem Cell Transplantation: A Case Report and Literature Review. Int J Dent 2021; 2021:6662381. [PMID: 34497645 PMCID: PMC8419498 DOI: 10.1155/2021/6662381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/23/2021] [Accepted: 07/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Secondary solid cancers are severe complications in patients who have undergone allogeneic hematopoietic stem cell transplantation (AHSCT) for malignant and nonmalignant lymphohematopoietic diseases. Objective The aim of this work was to report a case of two lip carcinomas following AHSCT and to warn doctors about the importance of regular check-ups of patients who have received HSCT. Observation. A 57-year-old man was referred by the dermatology department for the management of exophytic budding lesions on the lower lip evolving since 5 months. The patient was in complete remission following allogeneic bone marrow transplantation for acute myeloid leukemia since five years. Clinical and histological findings confirmed the diagnosis of a squamous cell carcinoma of the two lesions. Conclusion It is of paramount importance to seek an oral squamous cell carcinoma in the presence of persistent lesions in HSCT recipients.
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Leuci S, Coppola N, Blasi A, Ruoppo E, Bizzoca ME, Lo Muzio L, Marano L, Risitano AM, Mignogna MD. Oral Dysplastic Complications after HSCT: Single Case Series of Multidisciplinary Evaluation of 80 Patients. Life (Basel) 2020; 10:life10100236. [PMID: 33050268 PMCID: PMC7600275 DOI: 10.3390/life10100236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 10/08/2020] [Indexed: 12/13/2022] Open
Abstract
Oral squamous cell carcinoma (OSCC) is the most common secondary solid malignancy after hematopoietic stem-cell transplantation (HSCT). OSCC following HSCT is frequently preceded by chronic graft-versus-host disease (cGVHD). The aim of this study was to describe a cohort of post-HSCT patients and to evaluate the onset of oral epithelial dysplasia and/or OSCC over time. In this retrospective cohort study, we present a cohort of hematological patients that underwent HSCT. Demographic variables, clinical hematological data, data regarding acute graft-versus-host disease (aGVHD) and cGVHD, and oral clinical features were analyzed. We focused on clinicopathological features of a subgroup of 22 patients with oral cGVHD and OSCC after HSCT. Among 80 included patients, 46 patients (57.5%) developed aGVHD and 39 patients (48.7%) developed cGVHD. Oral mucosa was involved in 17 patients with aGVHD (36.9%) and in 22 patients (56.4%) with cGVHD. Out of a total of 22 oral biopsies, roughly 40% revealed mild to moderate dysplasia, and 32% were OSCC. In the absence of international agreement on the best timing of oral follow-up after HSCT, it is mandatory to establish a close multidisciplinary evaluation in order to prevent the onset of HSCT-related OSCC and to reduce post-transplant mortality due to secondary tumors.
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Affiliation(s)
- Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (A.B.); (E.R.); (M.D.M.)
| | - Noemi Coppola
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (A.B.); (E.R.); (M.D.M.)
- Correspondence: ; Tel.: +39-3392602615
| | - Andrea Blasi
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (A.B.); (E.R.); (M.D.M.)
| | - Elvira Ruoppo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (A.B.); (E.R.); (M.D.M.)
| | - Maria Eleonora Bizzoca
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.B.); (L.L.M.)
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy; (M.E.B.); (L.L.M.)
| | - Luana Marano
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80138 Naples, Italy;
| | | | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Oral Medicine Unit, Federico II University of Naples, 80138 Naples, Italy; (S.L.); (A.B.); (E.R.); (M.D.M.)
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Chaulagain CP, Sprague KA, Pilichowska M, Cowan J, Klein AK, Kaul E, Miller KB. Clinicopathologic characteristics of secondary squamous cell carcinoma of head and neck in survivors of allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Bone Marrow Transplant 2018; 54:560-566. [PMID: 30127467 PMCID: PMC6484708 DOI: 10.1038/s41409-018-0299-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Revised: 06/17/2018] [Accepted: 06/24/2018] [Indexed: 01/23/2023]
Abstract
The risk of late complications including secondary malignancies is increased in long-term survivors of allogeneic hematopoietic stem cell transplants (HSCT). There is limited literature on the biological behavior and clinical features of squamous cell carcinoma (SCC) of head and neck post-HSCT. We present the clinical and pathologic characteristics on six patients who were diagnosed with SCC while in remission following an allogeneic HSCT. Median follow-up was 8 years. Five patients (83%) developed SCC of tongue and one developed esophageal SCC. Five patients had oral chronic graft-versus-host disease (cGvHD). The conventional risk factors of alcohol, tobacco, and human papillomavirus were absent. The most common presenting finding was the new-onset focal oral pain and ulcerated plaques clinically indistinguishable from a flare of their oral cGvHD lesions. We demonstrated that the SCC in three patients was of donor origin.
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Affiliation(s)
- Chakra P Chaulagain
- Taussig Cancer Institute of Cleveland Clinic, Maroone Cancer Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA
| | - Kellie A Sprague
- Department of Medicine, Division of Hematology and Oncology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Monika Pilichowska
- Department of Pathology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Janet Cowan
- Department of Pathology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Andreas K Klein
- Department of Medicine, Division of Hematology and Oncology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Esha Kaul
- Department of Medicine, Division of Hematology and Oncology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA
| | - Kenneth B Miller
- Department of Medicine, Division of Hematology and Oncology, Tufts Medical Center and Tufts University School of Medicine, Boston, MA, USA.
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Schlieve T, Heidel RE, Carlson ER. Second Primary Head and Neck Cancers After Non-Head and Neck Primary Cancers. J Oral Maxillofac Surg 2016; 74:2515-2520. [DOI: 10.1016/j.joms.2016.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 05/09/2016] [Accepted: 05/10/2016] [Indexed: 12/30/2022]
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Mann JM, Kellman RM, Hahn SS, de la Roza GL, Gajra A. Radiation-induced epithelial-myoepithelial carcinoma in a patient previously treated with mantle-field radiation therapy for Hodgkin lymphoma. Head Neck 2015; 37:E96-8. [PMID: 25242451 DOI: 10.1002/hed.23873] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2014] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Radiation-induced salivary gland tumors are well described in the literature, with mucoepidermoid cancer being the most common histologic entity. Epithelial-myoepithelial carcinoma is a rare tumor accounting for <1% of all tumors in the salivary glands. METHODS AND RESULTS We describe the first case of radiation-induced epithelial-myoepithelial carcinoma in the English-language medical literature. A 48-year-old man presented with right-sided mandibular pain and trismus, 25 years after mantle-field radiation therapy (RT) for Hodgkin lymphoma. He underwent excision of a right submandibular mass, which revealed a diagnosis of epithelial-myoepithelial carcinoma. Although typically a low-grade tumor, the histology revealed extensive necrosis and high mitotic activity. The patient required multiple resections and adjuvant therapy after multiple recurrences over a 4-year period. CONCLUSION Reports of epithelial-myoepithelial carcinoma are relatively rare and this case highlights the importance of long-term follow-up and increased awareness of the risks of salivary gland tumors in this population.
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Affiliation(s)
- Justin M Mann
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | - Robert M Kellman
- Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, Syracuse, New York
| | - Seung S Hahn
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York
| | | | - Ajeet Gajra
- Department of Hematology/Oncology, SUNY Upstate Medical University, Syracuse, New York
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Oral squamous cell carcinoma arising in a patient after hematopoietic stem cell transplantation with bisphosphonate-related osteonecrosis of the jaws. Case Rep Dent 2015; 2015:831418. [PMID: 25973278 PMCID: PMC4417975 DOI: 10.1155/2015/831418] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/01/2015] [Indexed: 12/02/2022] Open
Abstract
A 55-year-old man with a history of acute myeloid leukaemia treated with hematopoietic stem cell transplantation and with a 5-year history of bisphosphonate-related osteonecrosis of the jaws, following 12 cycles of intravenous zoledronic acid therapy, presented in December 2009 with a history of increasingly severe unilateral lower jaw pain. Oral examination revealed, as previously, exposed bone in the left mandible, but also a new exophytic mass on the lower-left buccal mucosa. Biopsy confirmed a diagnosis of oral squamous cell carcinoma. To the best of our knowledge, this is the first report of an oral squamous cell carcinoma that appeared adjacent to an area of osteochemonecrosis.
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