Oral Squamous Cell Carcinoma in Non-smoking Women: Three Case Reports
Letícia Albuquerque Rodrigues
Postgraduate Program in Health Sciences at the Federal University of Ceará – Sobral Campus, Brazil.
João Vitor Freitas da Silva
Postgraduate Program in Health Sciences at the Federal University of Ceará – Sobral Campus, Brazil.
Matheus Alves Gabriel
Postgraduate Program in Health Sciences at the Federal University of Ceará – Sobral Campus, Brazil.
Filipe Nobre Chaves
Postgraduate Program in Health Sciences at the Federal University of Ceará – Sobral Campus, Brazil.
Marcelo Bonifácio da Silva Sampieri
Postgraduate Program in Health Sciences at the Federal University of Ceará – Sobral Campus, Brazil.
Denise Hélen Imaculada Pereira de Oliveira *
Postgraduate Program in Health Sciences at the Federal University of Ceará – Sobral Campus, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Squamous cell carcinoma (SCC) accounts for approximately 90% of malignancies affecting the oral cavity. Although oral SCC is classically associated with tobacco and alcohol exposure, its occurrence in women who do not smoke or drink suggests a changing clinical and epidemiological profile. Case reports focusing on SCC of the lateral border of the tongue in this population remain limited.
Aim: This study reports three clinical cases of SCC located on the lateral border of the tongue in non-smoking and non-drinking women.
Presentation of Case: The patients were women aged 38, 46 and 49 years who sought care for non-healing tongue lesions. Case 1 involved a 46-year-old patient with a 20 mm leukoerythroplakic plaque of fibrous consistency and rough surface, present for 30 days. Case 2 involved a 49-year-old patient with a 14 mm ulcerated lesion with erythematous and indurated margins, fibrous consistency, a smooth surface and central fissuring, present for approximately 40 days. Case 3 involved a 38-year-old patient with a 15 mm plaque-like lesion of fibrous consistency and smooth surface extending to the dorsum of the tongue, present for approximately 60 days. Incisional biopsy confirmed moderately differentiated SCC in all three cases, with muscular invasion in Case 2 and muscular and perineural invasion in Case 3.
Discussion: The cases reinforce that tongue SCC can occur in women without traditional risk factors. Possible non-conventional factors, including HPV infection and molecular alterations, should be considered, although they were not investigated in these cases.
Conclusion: Persistent tongue lesions in non-smoking and non-drinking women require careful assessment, timely biopsy and multidisciplinary management.
Keywords: Oral squamous cell carcinoma, tongue cancer, non-smoking women, non-drinking patients, young adult, human papillomavirus