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Sansare K, Jadhav TS, Venkatraman S, Vahanwala S. Oral cancer in pregnancy: A systematic review. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101647. [PMID: 37783336 DOI: 10.1016/j.jormas.2023.101647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 09/23/2023] [Indexed: 10/04/2023]
Abstract
PURPOSE Oral cancers in pregnancy (OCiP) are rare, however when diagnosed it complicates both the treatment of cancer and the outcome of pregnancy. The aim of this systematic review was to assess the factors impacting the foetal and maternal outcome in OCiP. MATERIALS AND METHODS A systematic search was performed on the following electronic databases: PubMed, Scopus, ScienceDirect and Google Scholar. Only histopathologically diagnosed cases of oral cancer in pregnant patients were included. The Joanna Briggs Institute questionnaire for case reports was used to assess the risk of bias. Logistic regression analysis was used to assess the factors impacting foetal and maternal outcome. RESULTS Out of the 40 cases reported, 28 were squamous cell carcinomas and 7 osteosarcomas. Logistic regression analysis demonstrated a non-significant association between age of patient, staging, trimester and treatment to maternal and foetal outcome. The overall recurrence, maternal death and foetal death for OCiP was 25 %, 30.77 % and 3.45 % respectively. CONCLUSION It could be concluded with low evidence level that none of the factors explored in this SR affected the maternal and foetal outcome. A regular oral check-up, particularly the tongue of pregnant females is recommended to identify any early signs of inflammation or oral cancer and subjected to biopsy to identify malignancy or dysplasia.
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Affiliation(s)
- Kaustubh Sansare
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India.
| | - Tanushree S Jadhav
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India
| | - Sreenivasan Venkatraman
- Oral Medicine and Maxillofacial Radiology, Bharathi Vidyapeeth Dental College and Hospital, CBD Belapur, Navi Mumbai, India
| | - Sonal Vahanwala
- Oral Medicine and Maxillofacial Radiology, Nair Hospital Dental College, Mumbai, India
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Gissi DB, Gabusi A, Tarsitano A, Rossi R, Balbi T, Morandi L. Multi-Region Sequence Analysis of a Pregnancy-Related Oral Squamous Cell Carcinoma Exhibiting Low-Level Aggressive Behavior. Int J Surg Pathol 2019; 28:188-195. [PMID: 31544567 DOI: 10.1177/1066896919876058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We analyzed the genetic and epigenetic profiles of an oral squamous cell carcinoma affecting a 41-year-old pregnant female. The patient presented with an oral mass located at the hard and soft palate with bone involvement and lymph node metastases (T4N1M0). She had been treated with multimodal radiotherapy and chemotherapy, and she is currently alive with no evidence of disease 8 years after treatment. DNA methylation and DNA mutation analyses were used to analyze multiple samples from the tumor mass and from the non-neoplastic mucosa to verify tumor heterogeneity. Genetic and epigenetic analyses revealed the presence of one shared TP53 driver mutation with the same DNA methylation profile in each of the 3 areas of the tumor mass; only 2 additional passenger mutations were detected, suggesting a simple clonal homogeneous carcinoma, which usually is associated with low-level aggressive behavior. Additionally, no genetic or epigenetic alteration in the non-neoplastic oral mucosa was detected, demonstrating the absence of field cancerization. The low aggressiveness of the lesion was confirmed by the patient being free of disease at a long-term follow-up examination. These data suggest a different molecular transformation pathway in pregnancy-related oral squamous cell carcinomas, providing new perspectives for further investigation.
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Sato K, Shimamoto H, Mochizuki Y, Hirai H, Tomioka H, Shimizu R, Marukawa E, Fukayama H, Yoshimura R, Ishida H, Harada H. Treatment of oral cancers during pregnancy: a case-based discussion. J Otolaryngol Head Neck Surg 2019; 48:9. [PMID: 30717781 PMCID: PMC6360730 DOI: 10.1186/s40463-019-0331-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 01/28/2019] [Indexed: 11/30/2022] Open
Abstract
Background Malignancies occur in approximately 1:1000 pregnancies; the most common being breast (46%) and hematological (18%) malignancies. Oral cancers account for only 2% of all cancers in pregnant women, and there are no standard guidelines for the treatment of oral cancer during pregnancy. Methods Between 2007 and 2014, our department managed 1109 patients with oral cancers; four (0.4%) had tongue carcinomas during pregnancy. These cases were retrospectively reviewed. Results The four women were aged 29–39 (median 32.5) years. Two underwent partial glossectomy at 39 and 40 weeks’ gestation, respectively, one received radiotherapy at 17 weeks’ gestation, and one underwent supraomohyoid neck dissection and hemi-glossectomy with a forearm flap reconstruction. Conclusion In addition to tumor factors, the wishes of the patient and her family, gestational age, and fetal and maternal conditions are important factors in deciding on a treatment protocol. Moreover, treatment decisions require multidisciplinary approach.
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Affiliation(s)
- Kiyoshi Sato
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan.
| | - Hiroaki Shimamoto
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Yumi Mochizuki
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hideaki Hirai
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Hirofumi Tomioka
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Risa Shimizu
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Eriko Marukawa
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Haruhisa Fukayama
- Department of Anesthesiology and Clinical Physiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryoichi Yoshimura
- Department of Radiation Therapeutics and Oncology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroo Ishida
- Department of Medical Oncology, Showa University School of Medicine, Tokyo, Japan
| | - Hiroyuki Harada
- Department of Oral and Maxillofacial Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8549, Japan
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Miyazaki Y, Fukuda K, Fujita K, Nishimoto S, Terada T, Wada R, Sotsuka Y, Kawai K, Kakibuchi M. Free flap transfer reconstruction in managing tongue carcinoma during pregnancy. J Surg Case Rep 2017; 2017:rjx164. [PMID: 28928919 PMCID: PMC5597873 DOI: 10.1093/jscr/rjx164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 07/19/2017] [Accepted: 07/25/2017] [Indexed: 12/17/2022] Open
Abstract
Malignant oral cancers do not commonly occur in pregnant women. But when they do, the presence of a foetus and maternal physiological changes complicate and limit the treatment options. Risk benefit assessment and balancing of them are always important. A 33-year-old woman, who was 25 weeks pregnant, presented with a squamous cell carcinoma on her tongue. She was clinically staged II (T2, N0 and M0). Discussions between the patient, surgical teams and obstetricians agreed to continue her pregnancy while managing the tumour. Hemi-glossectomy and ipsilateral neck dissection was performed. Free antero-lateral thigh flap was transferred to reconstruct the tongue defect, successfully. The patient gave birth to a healthy baby afterward. She is tumour free for 6 years. Free flap reconstruction can be an option, even if the patient is pregnant.
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Affiliation(s)
- Yuko Miyazaki
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Kenji Fukuda
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Kazutoshi Fujita
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Soh Nishimoto
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Tomonori Terada
- Department of Otolaryngology, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Ryu Wada
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Yohei Sotsuka
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Kenichiro Kawai
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
| | - Masao Kakibuchi
- Department of Plastic Surgery, Hyogo College of Medicine, Hyogo 663-8501, Japan
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Murphy J, Berman DR, Edwards SP, Prisciandaro J, Eisbruch A, Ward BB. Squamous Cell Carcinoma of the Tongue During Pregnancy: A Case Report and Review of the Literature. J Oral Maxillofac Surg 2016; 74:2557-2566. [DOI: 10.1016/j.joms.2016.06.173] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 06/11/2016] [Accepted: 06/13/2016] [Indexed: 12/11/2022]
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Grimm M, Biegner T, Teriete P, Hoefert S, Krimmel M, Munz A, Reinert S. Estrogen and Progesterone hormone receptor expression in oral cavity cancer. Med Oral Patol Oral Cir Bucal 2016; 21:e554-8. [PMID: 27475696 PMCID: PMC5005091 DOI: 10.4317/medoral.21182] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 05/03/2016] [Indexed: 12/15/2022] Open
Abstract
Background Recent studies have shown an increase in the incidence of oral squamous cell carcinoma (OSCC) in younger patients. The hypothesis that tumors could be hormonally induced during pregnancy or in young female patients without the well-known risk factors alcohol or tobacco abuse seems to be plausible. Material and Methods Estrogen Receptor alpha (ERα) and Progesterone Receptor (PR) expression were analyzed in normal oral mucosa (n=5), oral precursor lesions (simple hyperplasia, n=11; squamous intraepithelial neoplasia, SIN I-III, n=35), and OSCC specimen. OSCCs were stratified in a young female (n=7) study cohort and older patients (n=46). In the young female study cohort three patients (n=3/7) developed OSCC during or shortly after pregnancy. Breast cancer tissues were used as positive control for ERα and PR expression. Results ERα expression was found in four oral precursor lesions (squamous intraepithelial neoplasia, SIN I-III, n=4/35, 11%) and in five OSCC specimen (n=5/46, 11%). The five ERα positive OSCC samples were older male patients. All patients within the young female study cohort were negatively stained for both ERα and PR. Conclusions ER expression could be regarded as a seldom risk factor for OSCC. PR expression seems to be not relevant for the development of OSCC. Key words:Oral squamous cell carcinoma, estrogen receptor, progesterone receptor, hormone receptor.
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Affiliation(s)
- M Grimm
- Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen, Osianderstrasse 2-8, 72076, Tuebingen, Germany,
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