A case report on the simultaneous occurrence of cancer in The Tongue and Breast

Abstract

Squamous cell carcinoma (SCC) affecting the tongue commonly emerges along its lateral border, yet occurrences specifically on the dorsum, especially at the midline, are notably rare. This study delves into the incidence rates of SCC localized on the tongue, alongside an investigation into simultaneous lesions of the breast. 50-year-old female presented with an ulcerative growth on the left side of the tongue, accompanied by speech difficulty and chewing discomfort persisting for a month. Previous history included breast surgery five years prior, along with ongoing diabetes medication. No history of habits, trauma, or prior ulcer formation was reported. Clinical examination revealed a whitish-yellow, firm, ulcerative lesion extending on the left lateral tongue surface, measuring 7.2x3.1x2.5cm with an exophytic growth of 4.7x2.1cm. The lesion, extending to the dorsal tongue surface, displayed erythematous flooring interspersed with slough and pale mucosa. Limited tongue movement and palpable submandibular nodes were noted. Initial diagnostic findings indicated stage IV metastatic carcinoma of the tongue (T4aN2M1). pathology revealed severe epithelial dysplasia with an invasive pattern in the form of islands, demonstrating altered cellular features, pleomorphism, inflammatory infiltrate, vascularity, and areas of hemorrhage. Lymph nodal analysis showed metastatic deposits in one of three left level II B lymph nodes.