Squamous cell carcinoma of the tongue occurring as a subsequent malignancy in a 12-year-old acute leukemia survivor.

Squamous cell carcinoma of the tongue is rare in children and previously unreported as a second malignancy after survival of acute leukemia. Usual etiologic associations such as smoking and alcohol use are not commonly seen in this population, and exposure to immunosuppressive and antineoplastic agents including radiation therapy may contribute to the occurrence of these tumors. A review of the literature reveals only 21 previously reported cases of squamous cell carcinoma of the tongue in children less than 15 years old, and in only two cases was it a second malignancy; none were in leukemia survivors. Small numbers prevent accurate conclusions with regard to tumor behavior, but prognosis appears to be poor with aggressive invasion and early metastasis common. Follow-up of survivors of leukemia and its therapy with immunosuppressive and cytotoxic drugs and radiation should include regular careful head and neck examinations.