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Tongue Cancer in Children on the Rise

Tongue Cancer in Children on the Rise

Tongue Cancer in Children on the Rise

Journal of Oral and Maxillofacial Surgery, 2021-06-01, Volume 79, Issue 6, Pages 1385-1386, Copyright © 2021 The American Association of Oral and Maxillofacial Surgeons

Uncovering the Facts About Rare Childhood Tongue Cancer

Oral cavity squamous cell carcinoma (OCSCC) – most commonly found on the tongue – is rare among those under the age of 21, and little is understood about risk factors for that age group. To better understand the disease, researchers at the University of Michigan analyzed 3 clinical cases (patients ages 16 ( Fig. 1 ), 18 and 20) and reviewed 108 cases in 64 studies published over the past 100 years.

Final tongue reconstruction in 16-year-old.
FIG. 1
Final tongue reconstruction in 16-year-old.

Their findings are presented in the June 2021 article “Squamous Cell Carcinoma of the Tongue in Young Patients: A Case Series and Literature Review” in the Journal of Oral and Maxillofacial Surgery ( JOMS ).

What Are the Risk Factors for Tongue Cancer in Young Patients?

In adults, the risk factors for oral tongue cancer typically are the use of tobacco and alcohol. In younger patients, most cases of oral tongue cancer are not associated with a known predisposing condition. Some risk factors for those under 21 are connected to:

  • Specific inherited genetic syndromes such as xeroderma pigmentosum (a rare recessive skin disorder) and Keratosis Ichthyosis Deafness (which causes rough scaly skin and hearing loss).

  • Those who are immunosuppressed secondary to blood disorders such as Fanconi anemia (a rare disorder that causes a variety of congenital anomalies) and chemotherapy.

  • Bone marrow transplant recipients.

What Is Known About Tongue Cancer in Young Patients?

Even though those under 21 make up only about .6% of all tongue cancer patients, studies found there are increasing numbers of tongue cancer in young people as compared to adults. Other study findings include:

  • The largest uptick in reported cases are noted for young white females.

  • The majority of cases for those under 21 are never-smokers and never-drinkers.

  • Children may have better disease-specific survival than adults.

  • The cases in young patients are more likely to be treated surgically.

  • One study found that children treated with surgery alone (vs. surgery and radiation) may have a significantly improved disease-specific survival rate.

What Do the Studies Tell Us About Young Tongue Cancer Patients?

The literature review covering 108 cases revealed:

  • 49 percent of patients were between ages 16 and 20; 32.3 percent were ages 11-59; the remaining 18.8 percent were ages 10 or younger.

  • A high percentage of patients presented with early-stage disease – but with a higher rate of nodal metastasis. The nodal disease rate may speak to a delay in treatment for a population not considered at high risk for oral cancer.

  • While data were inconsistently reported, the survival rate for younger patients at 5 years post-treatment was calculated at 43.6 percent – compared to the adult 5-year survival rate of 66 percent.

  • Three patients had mutations in tumor suppressor genes that can be caused by a number of human cancers.

  • Two patients had a history of human growth hormone replacement therapy.

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