Squamous cell carcinoma involving the midline of the dorsum of the tongue: a case report

Abstract

Introduction: Most cases of squamous cell carcinoma (SCC) of the tongue occur on the lateral surface; however, SCC of the dorsum is extremely rare.

Case presentation: The authors describe the case of a 79-year-old man with SCC involving the midline of the dorsum of the tongue. The lesion was surgically resected. The patient was followed up for 1 year and 6 months, and no recurrence was noted.

Discussion: SCC of the dorsal midline is even rarer and accounts for less than 1% of tongue carcinomas. SCC involving the dorsum may have a worse prognosis than SCC of the lateral or ventral surface. This report is the first to use submental flap reconstruction to treat cancer of the midline dorsum of the tongue.

Conclusion: The authors encountered a case of SCC involving the midline of the dorsum of the tongue, which has rarely been reported in the literature. The authors attained a favorable outcome through surgical intervention.

Keywords: chronic hyperplastic candidiasis; dorsum of the tongue; head and neck cancer; squamous cell carcinoma; submental island flap.

Figure 1

Preoperative intraoral photograph. An ulcerative lesion with induration measuring 26.0×35.0 mm was found on the midline of the tongue dorsum.

Figure 2

Preoperative examination. T2-weighted magnetic resonance imaging revealed a relatively well-demarcated high-intensity signal at the midline of the tongue dorsum. The lesion measured 35.0×26.0 mm, with a depth of 12 mm.

Figure 3

Intraoperative photographs. (A) Design line for tongue resection. (B) Intraoperative photograph after tongue resection. (C) Design line for submental flap. A 60×40 mm spindle-shaped flap was designed. (D) Intraoperative photograph of submental flap reconstruction.

Figure 4

Postoperative intraoral photograph. The tumor was resected with a 10 mm margin set around the tumor. Submandibular triangle dissection and submental island flap reconstruction were then performed.