Basaloid Squamous Cell Carcinoma of the Midline Dorsal Tongue: Case Report and Review of the Literature.
Jacob E Kapustin, Sabrina R Comess, Margaret Nurimba et al.
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Case in brief
A 76-year-old woman presented with irregular, exophytic, rugated and furrowed changes on the midline dorsal tongue. An outside biopsy was interpreted as mucoepidermoid carcinoma; MRI showed only mild linear enhancement of the oropharyngeal tongue. After midline partial glossectomy with intraoperative frozen-section analysis, final pathology identified pT2 invasive basaloid squamous cell carcinoma, with a depth of invasion of 2.43 mm, WPOI-3 and negative margins. The team chose surveillance without adjuvant therapy.
What made this case unusual
The tumor arose at the exceptionally uncommon midline dorsal tongue site and was initially misclassified as mucoepidermoid carcinoma, illustrating the potential for basaloid squamous cell carcinoma to mimic other entities histologically.
Diagnostic / clinical pearl
When a tongue lesion has atypical morphology or an unexpected biopsy diagnosis, assess the full histological features and use immunohistochemistry as appropriate to distinguish basaloid squamous cell carcinoma from mimics.
Why it matters
Accurate classification can inform management and prognosis, as basaloid squamous cell carcinoma may have different prognostic implications from the entities it resembles.