Oral Tongue Spontaneous Tumor Regression after Biopsy: A Case Report and Genomic Profile

Abstract

Spontaneous regression of a neoplasm is a rare oncologic phenomenon. Certain neoplasms, such as melanomas and neuroblastomas, display this phenomenon. To date, spontaneous regression of oral cavity squamous cell carcinomas has been documented in only a handful of case reports. We present a novel case of spontaneous regression of an oral tongue squamous cell carcinoma following biopsy. We discuss the tumor's unique genetic profile, immune response to cancer, and review the literature on possible mechanisms of spontaneous regression. Small-volume persistent cancer in our patient reinforces that tissue confirmation remains crucial to avoid missing remaining tumor. Further investigation is required to understand mechanisms of spontaneous regression and how these may be exploited to improve head and neck squamous cell carcinoma treatment.

Case Details

Disease Location

Tongue

Personal Characteristics

77-year-old woman. Active meniere’s disease and trigeminal neuralgia.

Clinical Characteristics

She complained of a 70-pound weight loss and worsening right tongue pain with increased dysphagia over the last two weeks. She was bothered by oral tongue irritation for several months. Oral examination revealed a 2x3 cm endophytic tumor on her right tongue. Punch biopsy at several locations in the right anterolateral tongue revealed invasive, poorly differentiated squamous cell carcinoma with predominantly lymphocytic inﬂammatory inﬁltrate.

Remission Characteristics

Approximately two weeks after the PET scan, the tongue mass had almost completely regressed. Pathology demonstrated marked tumor regression with only a minute focus of residual invasive SCC with surrounding chronic inﬂammatory cells and tumor apoptotic ﬁgures

Treatment & Mechanisms

Clinical Treatment

Biopsy