ADENOCARCINOMA ASINTOMÁTICO DE BASE DE LENGUA

Abstract

Introduction:We report the case of a patient presenting an asymptomatic base of the tongue adenocarcinoma.Case report:70-year-old woman with a medical history of hemilaminectomy D8 - D9 in 2014, with a non-diagnostic anatomopathological stuyd. In the follow up of the lession an MRI was performed and revealed a mass in the floor of the mouth, with radiologic findings compatible with squamous cell carcinoma or a lymphoma. The patient underwent a complete ENT examination, that only revealed a slight hypertrophy of the lingual tonsil.  A navigator-guided biopsy was performed under general anesthesia. The result of the anatomopathological study revealed a low-grade adenocarcinoma of the tongue base. The case was presented in the head and neck oncology board, where surgical treatment is the first option, and radiotherapy being the second. The patient is informed of the proposed treatments and declines the surgical option Discussion:The adenocarcinoma constitutes, within its rarity and, together with adenoid cystic carcinoma, the most frequent malignant tumor of the salivary glands. He has a predilection for adults around the fourth and sixth decades. It is found in the same percentage in major and minor salivary glands, although those of low grade settle more frequently in the latter. Although its most frequent location within the minor salivary glands are those of intraoral location, others have been described in 10% of patients: maxillary sinus, nasopharynx, nasal cavity, oropharynx, vocal cords, larynx and trachea. In the present case, and given its location in the oropharynx and tongue base, it is necessary to perform the differential diagnosis with other entities such as thyroglossal duct cyst, lingual thyroid, hyperplastic lymphoid tissue, lymphangioma, fibroma, lipoma, dermoid cyst, squamous cell carcinoma, lymphoma and other tumors of minor salivary glands. The management goes through an adequate extirpation in low grade tumors. Prognosis is determined by staging, complete excision and histological grade. Conclusion:Despite the low incidence of adenocarcinoma of the oral cavity, it must be considered in the differential diagnosis between neoplastic pathologies of said location.