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Role of midline raphe in compartmental surgery for squamous cell carcinoma of the tongue
Purpose
In the present study, we investigated how tumor distance from midline (TDFM) and depth of invasion (DOI) may affect survival outcomes after compartmental tongue surgery (CTS) for oral tongue squamous cell carcinoma (OTSCC).
Methods
A retrospective series of cT2-T3 OTSCC treated with upfront CTS at our Department from 2010 to 2021 was evaluated. Radiological and pathological DOI and TDFM were correlated. The main outcomes were overall (OS) and loco-regional recurrence free survival (LRRFS). The linear relationship between DOI and TDFM with 2-year OS and LRRFS was tested. Survival estimates were obtained by the Kaplan-Meier method. Univariate analysis was performed for variables of interest, and results expressed in terms of hazard ratios and 95% confidence intervals.
Results
A total of 64 patients underwent CTS and neck dissection. No significant difference was found between pathological (pDOI) and radiological DOI (rDOI) (
p
= 0.321) or between pathological (pTDFM) and radiological TDFM (
p
= 0.435). Two- and 5-year OS and LRRFS were 85.7% and 70.4%, 84.3% and 76.1%, respectively. A linear and significant relationship with OS (
p
= 0.020) and LRRFS (
p
= 0.013) was found for pDOI; although linear, the relationship between pTDFM was not statistically significant for either survival outcomes. Once categorized, the ideal cut-off for pDOI according to OS was set at 10 mm (
p
= 0.023).
Conclusion
In patients undergoing CTS for primary OTSCC, magnetic resonance-derived rDOI represents an accurate estimate of pDOI, In contrast, TDFM was not associated with OS suggesting that the median raphe is a safe deep margin for CTS.
protocol n.
BS/231,009 retrospectively registered.
Journal Article
Just joking 3 : 300 hilarious jokes about everything, including tongue twisters, riddles, and more!
A book of silly jokes, including knock-knocks, tongue twisters, riddles, traditional question and answer jokes, and more.
Book
Mucoepidermoid carcinoma of the base of the tongue: a case report and review of the literature
Background
Mucoepidermoid carcinoma originates from reserve cells present in ducts of salivary glands and is the most common malignancy of the salivary glands. It is commonly found in the parotid gland, followed by the palatal and buccal mucous membranes. However, mucoepidermoid carcinoma occurrence in other intraoral sites, including the tongue base, is extremely rare.
Case presentation
A 33-year-old Chinese man presented with a progressively enlarging mass at the base of his left tongue. Contrast-enhanced computed tomography and magnetic resonance imaging revealed an augmented soft tissue mass in the left jaw region with indistinct boundaries, enlargement of cervical lymph node of uncertain etiology, and no evidence of distant metastasis. A transoral needle biopsy from the mass pathologically revealed low-grade mucoepidermoid carcinoma. Complete transoral excision and cervical lymph node dissection were performed, followed by reconstruction with an anterolateral thigh free flap. Examination of the obtained surgical specimen confirmed low-grade mucoepidermoid carcinoma with
MAML2
gene fusion in the base of the tongue. The tumor was removed with negative margins, and the cervical lymph nodes were free of disease. The patient had an uneventful recovery and showed no evidence of recurrence or metastasis at 40 months of follow-up.
Conclusion
We present a rare case of mucoepidermoid carcinoma at the base of the tongue. Furthermore, we review related literature and discuss its clinical features, histopathological characteristics, and treatment strategies.
Journal Article
The big aqua book of beginner books
Collects four Dr. Seuss books, including \"The Cat in the Hat Comes Back!\" and the collection of tongue twisters \"Oh Say Can You Say?\" along with stories by Al Perkins and Robert Lopshire.
BOOK
Transdifferentiation of tongue muscle cells into cancer-associated fibroblasts in response to tongue squamous cell carcinoma
Tongue Squamous Cell Carcinoma (TSCC) represents a significant subtype of malignant oral cancer, characterized by a heterogeneous tumor microenvironment (TME). The tongue, a complex muscular organ, naturally presents an initial microenvironment that is largely inhospitable to the initiation and progression of TSCC. However, advanced-stage TSCC exhibits a pronounced accumulation of cancer-associated fibroblasts (CAFs), indicative of a drastic microenvironmental transformation. In this study, through comprehensive analysis combining cell model assessments and single-cell RNA sequencing data from a 4-NQO-induced TSCC mouse model, along with a lineage tracing-in-transplant assay, we elucidate and confirm the process of transdifferentiation whereby tongue muscle cells (TMCs) convert into CAFs in the TSCC context. Furthermore, we demonstrate that targeting TSCC with an IL-17a inhibitor offers a viable strategy to inhibit the reprogramming of TMCs into CAFs. Additionally, our research also identifies four critical marker genes involved in the transdifferentiation of TMCs to CAFs, Thbs1, Crabp1, Ifi205, and Cxcl5. Collectively, these findings delineate a mechanism through which TSCC cells induce the transdifferentiation of TMCs into CAFs, thereby transforming the cancer-suppressive microenvironment of the tongue into one that is conducive to TSCC progression.
Tongue Squamous Cell Carcinoma (TSCC) is a subtype of head and neck cancer with poor prognosis. Here, the authors show that TSCC influences the transdifferentiation of tongue muscle cells into cancer-associated fibroblasts, transforming the tumor microenvironment into a tumor-supporting microenvironment.
Journal Article
Terrific tongues!
\"[Readers] will learn about the woodpecker, which uses its tongue to burrow for insects under tree bark; the okapi, which can wash its face and ears with its tongue; and the octopus, which uses its tongue to drill holes in shells\"--Amazon.com.
Book
A SEER-based prognostic nomogram for early-stage (pT1-2N0M0) tongue squamous cell carcinoma and an observational analysis of postoperative radiotherapy
Background
To develop a nomogram for predicting overall survival (OS) and cancer-specific survival (CSS) in patients with postoperative early-stage (pT1-2N0M0) tongue squamous cell carcinoma (TSCC), and to explore the association between postoperative radiotherapy (PORT) and patient survival.
Methods
Data from 7,637 patients with pT1-2N0M0 TSCC who underwent surgery between 2000 and 2021 were extracted from the SEER database. Patients were randomly divided into a training cohort and a validation cohort in a 2:1 ratio. Prognostic factors were identified via Kaplan-Meier analysis and Cox regression, and a nomogram was constructed. To minimize confounding, propensity score matching (PSM) was used to compare outcomes between patients who received PORT and those who did not. Subgroup and interaction analyses were performed to assess potential effect modifiers.
Results
Of the 7,637 patients included, 1,336 (17.5%) received PORT. Multivariate Cox analysis identified age, race, marital status, grade, tumor size, lymph node (LN) removed status, and PORT as independent prognostic factors for OS and CSS. The nomogram demonstrated strong predictive performance based on time-dependent ROC curves, concordance indices, calibration plots, and decision curve analyses in both training and validation cohorts. After PSM, PORT remained associated with worse OS and CSS. Subgroup analyses revealed that the association between PORT and poorer OS was most evident in younger patients, married individuals, T1 stage patients, those with smaller tumors, and those without LN removal, with racial disparities also observed. For CSS, this association was more pronounced in married individuals, well-differentiated patients, T1 stage patients, those with smaller tumors, and those without LN removal.
Conclusion
The SEER-based nomogram provides survival predictions for postoperative pT1-2N0M0 TSCC patients. Although PORT was associated with worse survival in several subgroups, findings should be cautiously interpreted given the observational design and absence of key clinical variables (PNI, LVI, surgical margins). Prospective studies incorporating comprehensive clinicopathological data are warranted to confirm associations and guide individualized PORT decisions in early-stage TSCC patients.
Journal Article
Recurrent Malignant Melanoma on the Tongue: A Case Report and Review of the Literature
Background Melanoma of the oral mucosa is an uncommon cancer arising from the tissues lining the mouth. Among oronasal malignant melanomas, tongue melanoma makes up a mere 2%. Optimal treatments for this rare and often late‐stage disease remain elusive. However, surgery with free margins is considered the primary treatment and is often combined with other therapies such as neck dissection, adjuvant radiotherapy, chemotherapy, and immunotherapy. Case This case involves a 33‐year‐old woman with a history of malignant melanoma on her tongue. She had previously undergone a partial glossectomy and was on maintenance imatinib treatment for ~2 years. During her follow‐up, a new lesion was discovered on her tongue, which was confirmed to be malignant melanoma and was resected. The tumor exhibited a depth of invasion of 8 mm. All surgical margins were clear, with the closest margin being 3 mm. The lesion was reconstructed with a submental flap. Adjuvant radiotherapy was also given. The patient has been on maintenance follow‐up for 3 years with no signs of recurrence. Conclusion Malignant melanoma should be considered in the differential diagnosis of pigmented and non‐pigmented lesions of the tongue and oral mucosa. A thorough clinical evaluation, followed by histopathological and immunohistochemical examination of any suspicious lesions, is essential for early diagnosis. Early detection and prompt treatment are crucial for optimizing patient outcomes and improving survival rates.
Journal Article