A case of synchronous multiple oral papillary squamous cell carcinoma of the tongue and gingiva

Papillary squamous cell carcinoma (PSCC) is a rare disease that occurs mainly in the larynx and oropharynx in the head and neck region, and has rarely been reported in the oral cavity. In this study, we report a case of oral papillary squamous cell carcinoma (OPSCC) involving the tongue and gingiva simultaneously. A 70-year-old woman who was admitted to the department of cardiothoracic surgery at our hospital for conservative treat-ment of Stanford type B aortic dissection was referred to our department for oral examination and treatment because of a mass at the apex of her tongue and inadaptation of dentures. Intraoral examination revealed a 26 x 21-mm soft elastic papillary mass with a coarse surface on the tip of the tongue and a 27 x 18-mm well -circumscribed exophytic papillary mass on the left side of the lower gingiva. Biopsy was performed under local anesthesia and the masses were diagnosed as carcinoma in situ (CIS). She underwent resection of the tongue and left mandibular gingival tumors under general anesthesia. A 7-mm margin was made for tumor resection. The histopathological diagnosis was OPSCC at both sites. On immunohistochemical examination, pan-cytokeratin (AE1/AE3) staining was positive and p16 staining was negative. The MIB-1 index was 36.3% and p53-positive cells accounted for 4.4%. After 18 months, the patient has been well with no recurrence, but careful long-term monitoring is required.