Erdoğan FİŞEKÇİOĞLU, Belde ARSAN, Gözde TURGUT, Gürcan VURAL

Dilde mikroinvaziv karsinom: Bir olgu sunumu

Dünya Sağlık Örgütü raporuna göre oral skuamöz hücreli karsinom oral kavitenin en sık gö-rülen malignitesidir. Teşhis ve tedavideki ilerlemelere rağmen hastaların 5 yıllık sağkalım oranları belirgin bir şekilde iyileştirilememiştir. Oral kanserlerin erken evrede teşhisi bu sebeple önemlidir. Kliniğimize başvuran 55 yaşında erkek hasta sistemik olarak sağlıklıdır ve sigara kullanmadığını belirtmiştir. Hastanın yapılan ağız içi muayenesinde dil lateralinde yüzeyden kabarık hiperkeratotik lökoplaki tespit edilmiştir. Hasta lezyonun varlığından haberdar değildir ve herhangi bir klinik semptom yoktur. Eksizyonel biyopsi sonrasında yapılan histopatolojik incelemede yüksek dereceli displazi görülmüştür. Mikroskopik bir odakta bazal membran devamlılığının bozulduğu ve mikroinvaziv patern geliştiği gösterilmiştir. Histopatolojik olarak mikroinvaziv karsinom tanısı konulmuştur. Mikroinvaziv karsinom en erken evre malignitedir ve oral kanserlerin bu evrede teşhis edil-mesi, prognozun iyileştirilmesi ve sağkalım oranlarının arttırılması için önemli bir yere sahiptir.

Microinvasive carcinoma of the tongue: A case report

According to World Health Organization Report oral squamous cell carcinoma is the most common malignancy of the oral cavity. Despite many diagnostic and therapeutic advances patients' 5-year survival rates have not been significantly improved. Early diagnosis of oral carcinoma is the-refore important. Systemically healthy, 55 year-old male patient referred to our clinic stated that he does not smoke. Hyperkeratotic leukoplakia was observed on the lateral side of the tongue. The patient had no symptoms and the lesion was observed incidentally. The histopathological examina-tion, which was performed following excisional biopsy showed high grade dysplasia. Basal memb-rane continuity was lost in a microscopic focus and microinvasive pattern was observed. The diag-nosis was established as microinvasive carcinoma. Microinvasive carcinoma is the initial stage of malignancy and the diagnosis of such lesions at this stage is important for the improvement in prognosis and survival rates.

PDF

___

1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 count-ries. CA Cancer J Clin 2018; 68: 394-424.
2. Barnes L, Eveson JW, Reichert P, Sidransky D (eds). World Health Organization Classifica-tion of Tumours, Pathology & Genetics of Head and Neck Tumours. 1st ed. Lyon: IARC Press; 2005.
3. Amit-Byatnal A, Natarajan J, Shenoy S, Kamath A, Hunter K, et al. A 3 dimensional as-sessment of the depth of tumor invasion in microinvasive tongue squamous cell carcinoma--A case series analysis. Med Oral Patol Oral Cir Bucal 2015; 20: 645-650.
4. Warnakulasuriya S, Johnson NW, van der Waal I. Nomenclature and classification of poten-tially malignant disorders of the oral mucosa. J Oral Pathol Med 2007; 36: 575-580.
5. Gillison ML. Current topics in the epidemiology of oral cavity and oropharyngeal cancers. Head and Neck 2007; 29: 779-792.
6. Polat Akmansoy B, Namdar Pekiner F, Dönmez M, Alatlı C. Oral squamöz hücreli karsinom: 3 olgu sunumu. Atatürk Üniv Diş Hek Fak Derg 2018; 28: 239-244.
7. Neville BW, Damm DD, Allen CM, Bouqout JE. Epithelial Pathology, In: Oral and Maxillo-facial Pathology, 3rd ed. St. Louis, Saunders 2002: 419.
8. Shankar A, Gokul S. The dilemma of microinvasion. Head Neck Oncol 2014; 6: 30.
9. Wenig BM. Intraoperative Consultation (IOC) in Mucosal Lesions of the Upper Aerodiges-tive Tract. Head Neck Pathol 2008;2:131-144.
10. Pentenero M, Navone R, Motta F, Marino R, Gassino L, et al. Clinical features of microin-vasive stage I oral carcinoma. Oral Dis 2011; 17: 298-303.
11. Parkin DM, Bray F, Ferlay J, Pisani P: Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74e108.
12. Forastiere A, Koch W, Trotti A. Sidransky D. Head and neck cancer. N Engl J Med 2001; 345:1 890-1900.
13. Grizzle WE, Srivastava S, Manne U. The biology of incipient, pre-invasive or intraepithelial neoplasia. Cancer Biomark 2010; 9: 21-39.
14. Woolgar JA, Triantafyllou A. Pitfalls and procedures in the histopathological diagnosis of oral and oropharyngeal squamous cell carcinoma and a review of the role of pathology in prognosis. Oral Oncol 2009; 45: 361-385.