Nonulcerated lesion with hardening of the tongue: sarcoma or squamous cell carcinoma?

Abstract

Nonulcerated tumors located in the tongue region, with movement limitation, are frequently associated with malignant tumors of mesenchymal tissues, with rhabdomyosarcoma being the most common. A 44-year-old female presented a symptomatic mass located on the right ventral surface of the tongue, firm on palpation, limiting it´s movement, without lymphadenopathy. The main clinical hypothesis was sarcoma. The magnetic resonance imaging revealed an invasive and infiltrative lesion, compromising the whole base of the tongue and extending to the floor of the mouth. The patient underwent an incisional biopsy, and the trans-surgical hypothesis was squamous cell carcinoma (SCC), considering its color and hardness aspects. The histopathologic analysis reported invasive islands and cords of malignant squamous epithelial cells, immunohistochemical panels were positive for cytokeratin, p63, p40, CAM 5.2 and Ki-67. The final diagnosis was poorly differentiated SCC, and the patient was referred to the local cancer hospital