A case of tongue cancer in a patient with chronic graft-versus-host disease after hematopoietic stem cell transplantation

Abstract

Hematopoietic stem cell transplantation （HSCT） is established as an effective treatment for patients with hematologic malignancies. However, chronic graft-versus-host disease （GVHD） after transplantation is a risk factor for the development of secondary solid cancer. We report a case of tongue cancer in a patient with chronic GVHD following allogeneic HSCT. The patient was a 57-yearold woman who underwent autologous peripheral blood stem cell transplantation （PBSCT） in 2009 after the diagnosis of acute myelocytic leukemia. A relapse occurred in 2011 and she underwent allogeneic PBSCT. She was diagnosed with chronic GVHD in 2013. Immunosuppressive agents and corticosteroids were administered for the treatment of chronic GVHD and the accompanying nephrotic syndrome. In 2016, right tongue cancer （cT1N0M0） developed and partial tongue resection was performed. However, 4 months later, a superior internal jugular node metastasis was detected. A conservative neck dissection was performed and one metastatic lymph node was histopathologically diagnosed. At a follow-up examination 1 year and 6 months later, there was no evidence of a recurrence or metastasis. In the present case, oral chronic GVHD and several years of immunosuppression may have been involved in the development of tongue cancer.