Basaloid Squamous Cell Carcinoma of the Dorsum of the Tongue Following Chronic Hypertrophic Candidiasis: A Case Report and Literature Review

TL;DR

A rare case of aggressive tongue cancer following a long-term fungal infection is reported, highlighting the need for close monitoring of such conditions.

Contribution

This is the first reported case linking basaloid squamous cell carcinoma to prior chronic hypertrophic candidiasis.

Findings

A 64-year-old man with a history of CHC developed BSCC 15 years later.

Chronic inflammation from CHC, alcohol use, and diabetes may have contributed to cancer development.

The patient showed no recurrence 23 months after combined treatment including surgery and chemotherapy.

Abstract

Basaloid squamous cell carcinoma (BSCC) is a rare and aggressive subtype of squamous cell carcinoma (SCC). The prognosis of patients with BSCC is worse than that of patients with normal SCC. Chronic hyperplastic oral candidiasis (CHC) is characterized by proliferative changes in the epithelial tissues and is associated with a high risk of carcinogenesis. We herein report a case of BSCC of the dorsum of the tongue following CHC. The patient was a 64-year-old man; Candida albicans was detected on the dorsal surface of his tongue in 2007. He was followed at our hospital under a diagnosis of CHC. In 2022, a 35×20 mm area of erythematous mucosa surrounded by white spots and induration was found in the same region, and a biopsy revealed a diagnosis of poorly differentiated SCC. After combination treatment with paclitaxel, carboplatin, and cetuximab (PCE) induction chemotherapy (PCE), the patient underwent neck dissection, hemiglossectomy, and oral reconstruction using an anterolateral thigh skin flap under general anesthesia. The final diagnosis was BSCC, and there was no evidence of recurrence or metastasis at 23 months postoperatively. To our knowledge, this is the first report of a case of BSCC following tongue CHC. In this case, chronic inflammation caused by CHC, chronic alcohol consumption, and diabetes mellitus may have been associated with the development of BSCC. Considering the potential role of CHC in the development of malignant diseases, careful and continuous follow-up is required.

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