Adenocarcinoma not otherwise specified on dorsum of tongue: case report and literature review

Abstract

Primary adenocarcinoma of the oropharynx most often arises from the minor salivary glands, and primary squamous cell carcinoma is more commonly seen arising from the tongue. Few cases of adenocarcinoma not otherwise specified of the tongue have been reported in the literature, and none found on the dorsum of the tongue. Successful treatment strategies have therefore not been defined.We report a case of adenocarcinoma located on the dorsum of the posterior one third of the tongue adjacent to the circumvallate papillae in a woman presenting with globus sensation and mild dysphagia. Treatment consisted of transoral laser excision and postoperative external-beam radiotherapy, resulting in disease-free survival at her 5-year follow-up. The goals of this report are to present a case of adenocarcinoma arising from the minor salivary gland located on the dorsum of the tongue, to discuss previous reports of similar cases, and to suggest that surgery with or without radiotherapy be used as the mainstay of treatment.

Keywords: Adenocarcinoma; base of tongue; minor salivary gland; radiation therapy.

FIGURE 1

Computed tomography imaging performed at the time of diagnosis. Red arrows indicate the location of the lesion. (A) Sagittal view. Superficial nodular lesion visible at base of tongue extending to the adjacent uvula. D = measured diameter of lesion (1.55 cm). (B) Axial view. Subtly enhancing lesion at right base of tongue, extending to the anterior aspect of the uvula, with no apparent invasion into the deep structures of the tongue. No significant lymphadenopathy noted.

FIGURE 2

Histology sections of adenocarcinoma not otherwise specified of minor salivary gland origin. (A) Low-power photomicrograph of the lesion, demonstrating its well-circumscribed nature in the submucosa. (B) Medium-power photomicrograph demonstrating arrangement of the neoplastic cells in cribriform nests, sheets, and focal tubules. (C) High-power photomicrograph of the neoplasm, demonstrating its cytologic features.