Case Report
Head and Neck Oncology
A patient with untreated tongue carcinoma surviving for 15 years

https://doi.org/10.1016/j.ijom.2004.06.012Get rights and content

Abstract

A rare case of untreated tongue carcinoma survived for 15 years is presented. A 43-year-old Japanese woman was referred to our department with a 1.8 cm × 1.0 cm white and red non-indurated lesion of the left border of the tongue. The histological examination showed a diagnosis of well-differentiated squamous cell carcinoma. We informed the patient and her family that she had a Stage I tongue carcinoma and needed to receive treatment immediately. However, they refused treatment. Fifteen years later, the patient presented again, complaining of a 55 mm × 40 mm painful gradual-growth swelling of the same site as before, and the clinical stage was T3N2aM0 (Stage IV). The patient agreed to receive radical surgery following preoperative chemoradiotherapy this time. Currently the patient has been free of recurrence for 4 years. Clinical and immunohistochemical features of this rare case are presented and discussed.

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Case report

A 43-year-old Japanese woman was referred to our department from a city hospital with a 1.8 cm × 1.0 cm white and red non-indurated lesion of the left border of the tongue on 22 November 1984 (Fig. 1). The histological examination of the biopsy specimen provided a diagnosis of well-differentiated squamous cell carcinoma (SCC). The SCC showed that the pattern of invasion and the depth of invasion were invasion by solid cords, bands and strands involving only lamina propria (Fig. 2). Physical

Discussion

Clinicians sometimes experience cancer patients who refuse treatment even though their cancers are still in early stages and the patients are persuaded strongly by their doctors. Stell et al.10 specifically reviewed patients not treated for their squamous cell carcinomas of the head and neck of 1977 patients: 15% of all patients were untreated and the most common reason for not treating the patients was that the carcinoma was too extensive (55%); a further 36% were too old or too infirm to be

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