Desmoplastic squamous cell carcinoma of the tongue simulating myositis or fasciitis

Abstract

An unusual form of squamous cell carcinoma of the tongue is reported, the "de novo" submucosal evolution of which is unique. Histologic definition of this malignancy and its distinction from clinically similar benign and malignant conditions are detailed through a brief review of the relevant differential diagnoses. The importance of circumspect diagnostic reassessment when the clinical behavior of a lesion contradicts apparent histologic benignancy is emphasized and treatment inferences are drawn.

Symptomatic macroglossia and tongue myositis in polymyositis: Treatment with corticosteroids and intravenous immunoglobulin

“…Another condition to be considered in the differential diagnosis is carcinoma of the tongue, which can simulate focal tongue myositis (10,11) or cause dermatomyositis (12). Therefore, the need for muscle biopsy must be emphasized in patients presenting with inflammatory muscle disease and suspected to have tongue myositis, in order to exclude the possibility of a neoplastic disorder.…”

Sclerosing Squamous Cell Carcinoma of the Skin, An Underemphasized Locally Aggressive Variant: A 20-Year Experience

“…1 In the oral cavity, Norris and colleagues reported two examples of desmoplastic SCC that were initially misinterpreted as nodular fasciitis. 3 Both patients had a poor outcome, with one dying from uncontrolled local disease and one developing metastatic disease, but the delay in diagnosis may have been contributory.…”

“…The association between desmoplasia and SCC, described clinically as “sclerosing SCC,” has previously been reported involving the breast, tongue, and lung, 1–3 although surprisingly little has been published within the dermatology literature. In other organ systems, there are insufficient data to assess the significance of desmoplasia upon the prognosis of SCC.…”

“…In the breast, Eggers and Chesney concluded that the presence of desmoplasia conferred no worse prognosis than with ductal adenocarcinomas of similar size and node status, but only eight neoplasms were included in the study 1 . In the oral cavity, Norris and colleagues reported two examples of desmoplastic SCC that were initially misinterpreted as nodular fasciitis 3 . Both patients had a poor outcome, with one dying from uncontrolled local disease and one developing metastatic disease, but the delay in diagnosis may have been contributory.…”

“…Desmoplastic responses to carcinoma and other neoplasms have been widely described. Desmoplasia, the induction of a densely collagenous stroma, has been noted in squamous cell carcinoma (SCC) of a variety of tissues, including the breast, oral cavity, and lung, 1–3 but the importance of desmoplasia in association with primary SCC of the skin has rarely been evaluated. Over the past 2 decades, we have observed a highly infiltrative type of SCC in which the neoplastic cells are associated with desmoplastic stroma.…”