Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Universities and Colleges Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Guangxi Clinical Research Center for Craniofacial Deformity, China; Guangxi Key Laboratory of AIDS Prevention and Treatment, Guangxi Medical University, Nanning, Guangxi, China.
Department of Periodontics and Oral Medicine, College of Stomatology, Guangxi Medical University, Nanning, Guangxi, China; Guangxi Health Commission Key Laboratory of Prevention and Treatment for Oral Infectious Diseases, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction, Guangxi Universities and Colleges Key Laboratory of Oral and Maxillofacial Surgery Disease Treatment, Guangxi Clinical Research Center for Craniofacial Deformity, China.
Oral Oncol. 2021 Oct;121:105399. doi: 10.1016/j.oraloncology.2021.105399. Epub 2021 Jul 1.
As a method to improve the survival rate of patients with hematological malignancies, allogeneic hematopoietic stem cell transplantation (allo-HSCT) has increasingly been used for treatment. However, some potentially serious complications after allo-HSCT, including graft-versus-host disease, graft failure, infection, end-organ toxicity, and secondary malignancies, will determine the success of hematopoietic reconstitution. Here, we describe a case of a patient with p16-positive tongue squamous cell carcinoma (TSCC) following allo-HSCT. A 62-year-old man who had previously received allo-HSCT due to acute lymphocytic leukemia (AML) presented with erosions on the back of the tongue surrounded by multiple white patches, which were compatible with oral chronic graft-versus-host disease (cGVHD). During follow-up, a circular-like erosive lesion appeared on the right dorsal surface of the tongue. Biopsy of this lesion confirmed early invasive TSCC (T2N0M0). Partial glossectomy and tongue reconstruction were performed after cessation of immunosuppressants. Immunohistochemical (IHC) staining was positive for p16 and ki-67, suggesting a probable active human papillomavirus (HPV) infection. Six months after surgery, the patient showed no signs of metastasis or recurrence nor progression of oral GVHD.
作为提高血液系统恶性肿瘤患者存活率的方法之一，异基因造血干细胞移植（allo-HSCT）越来越多地被用于治疗。然而，allo-HSCT 后可能会出现一些严重的并发症，包括移植物抗宿主病、移植物失败、感染、终末器官毒性和继发性恶性肿瘤，这些并发症将决定造血重建的成功与否。在这里，我们描述了一例 allo-HSCT 后发生 p16 阳性舌鳞状细胞癌（TSCC）的患者。一名 62 岁男性，因急性淋巴细胞白血病（AML）接受 allo-HSCT，出现舌背多处白色斑块环绕的糜烂，符合口腔慢性移植物抗宿主病（cGVHD）。随访期间，舌右侧背侧出现圆形糜烂性病变。该病变活检证实为早期浸润性 TSCC（T2N0M0）。停用免疫抑制剂后，行部分舌切除术和舌重建术。免疫组化（IHC）染色 p16 和 ki-67 阳性，提示可能存在人乳头瘤病毒（HPV）感染。术后 6 个月，患者无转移、复发或口腔 GVHD 进展迹象。
