A case of tongue cancer manifesting from oral leukoplakia after long-term administration of pegylated liposomal doxorubicin

Abstract

We present a case of tongue cancer manifestation from oral leukoplakia after administration of pegylated liposomal doxorubicin (PLD). A 56-year-old woman was diagnosed with ovarian cancer. After preoperative chemotherapy with paclitaxel and carboplatin (TC), she underwent interval debulking surgery. Five cycles of TC therapy were carried out as adjuvant chemotherapy; however, recurrence was observed. Despite administration of gemcitabine-carboplatin therapy, the patient's condition was judged as advancing to a progressive disease. PLD treatment was completed at a total dose of 1140 mg/m². Two months after the end of treatment, the patient was diagnosed with leukoplakia. The leukoplakia lesion became thicker at each 3-month follow-up. She was diagnosed with tongue cancer and underwent a partial resection 2 years and 3 months after the completion of PLD treatment. Our report suggests that the risk of malignant transformation to tongue cancer persists even after the completion of treatment with PLD.

Figure 1

Intraoperative images; (a) set a 10-mm surgical margin around the tumor before resection; (b) confirm unstained area with Lugol’s solution; (c) cut the deep part in a wedge shape; the resection margin is negative for cancer; (d) suture in a straight line.

Figure 2

Histopathological images; (A) thick, well-defined complex keratinization is identified in the superficial layer (black arrow); (B) the atypical cells were confined to one-half to one-third of the basal layer; these cells were markedly atypical; (C) loss of basal cell polarity, cellular and nuclear polymorphism, large nucleoli and single or groups of cells in the spinous and basal layers are present.