Non-Keratinizing Squamous Cell Carcinoma in the Tongue

Hernández-Guerrero Juan Carlos, Ciro Dantas Soares, Jimenez-Farfan, Maria Dolores, Rojas-Barrera Luis Uriel, Carlos Alberto Lara Gutiérrez, Ledesma-Montes Constantino and Durán-Padilla Marco Antonio

Immunology Laboratory, National Autonomous University of Mexico, Mexico
Department of Oral Diagnosis, Piracicaba Dental School, UNICAMP State University of Campinas, Brazil
Department of Dentistry, Health Science and Social Work Unit, University of Veracruz, Mexico
Department of Oncology, General Hospital of México "Eduardo Liceaga", National Autonomous University of Mexico, Mexico
Department of Pathology, General Hospital of México "Eduardo Liceaga", National Autonomous University of Mexico, Mexico

^*Correspondance to: Marco Duran Padilla 

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Abstract:

Objectives: This study aimed to know the clinical-pathological features of the Non-Keratinizing Squamous Cell Carcinomas (NKSCCs) arising in the tongue, classify them microscopically, and analyze their behavior, treatment and prognosis. Also, we challenge the opinion that NKSCCs histology strongly predicts HPV-association; comparing the clinicopathological findings of non-
HPV tested NKSCCs with data from previously reported HPV-positive cases.
Study Design: We selected all NKSCCs from the files of the Surgical Pathology Service at the Hospital General de México. Their clinicopathological data and slides were retrieved, analyzed, and compared with previously reported series of cases.
Results: Sixty percent of the analyzed tumors were in men (mean age = 56.5 years). Mean age was higher in men than in women, 33.3% of tumors invaded the floor of the mouth and 23.3% the submandibular salivary gland; 66.6% were T1-T2 tumors followed by T4 tumors for which the mean age was younger; 33.3% presented lymph node involvement. Microscopically, NKSCCs displayed well-defined morphological features and a non-keratinizing basal cell-like component as their main cytological feature. Two variants were found, the NKSCC and the hybrid-Squamous Cell Carcinoma (SCC). Hybrid SCCs comprised 83.3% of the neoplasms and were the most aggressive tumors, having more recurrences, presenting higher T scores and staging, and were the only tumors showing lymph node involvement. Tumors recurred more frequently in men and were more frequent in patients older than 50 years.
Conclusions: 1) Clinicopathological features and behavior of NKSCCs without HPV tests were similar to those previously published with HPV-positivity supporting the suggestion that adjuvant testing is not necessary since 100% of the NKSCC are p16 positive. 2) Hybrid SCCs were more common than NKSCCs. 3) Only hybrid SCCs developed lymph node involvement. 4) NKSCCs have a less aggressive behavior and better prognosis than hybrid SCCs. 5) NKSCC microscopic features
support the suggestion that its histology could predict HPV-association and these attributes are more important in prediction of outcome.

Keywords:

Squamous cell carcinoma; Head and neck; Tongue; Non-keratinizing carcinoma

Cite the Article:

Juan Carlos H-G, Soares CD, Jimenez-Farfan, Dolores M, Luis Uriel R-B, Lara Gutiérrez CA, et al. Non-Keratinizing Squamous Cell Carcinoma in the Tongue. Clin Oncol. 2022;7:1913..