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Carcinoma escamocelular bucal. Caso clínico y revisión de la literatura / Oral squamous cell carcinoma. Case report and review of literature

Martha Beatriz González-Guevara, Celia Linares-Vieyra, Mario Emmanuelle Castro-García, Marco Agustín Muñiz-Lino, Cinthia Abaroa-Chauvet, Francisco Bello-Torrejón

Resumen


Resumen

Introducción: el cáncer escamocelular (CEC) representa el 90-95% de todos los tipos de cáncer. En México, la frecuencia de CEC bucal (CECB) se ha incrementado y presenta una incidencia entre el 1 y el 5%. El CECB se asocia con sujetos en la quinta y séptima década de la vida, el sexo masculino, positivos a tabaquismo, alcoholismo, factores genéticos, inmunosupresión, infección por virus del papiloma humano (VPH) y estilos de vida poco saludables, entre otros. El objetivo de este trabajo fue presentar un caso clínico como ejemplo de las características emergentes en un paciente con CECB.

Caso clínico: mujer de 38 años, con úlcera indurada, parcialmente adherida a planos profundos y dolorosa, asociada con un aumento de volumen, ubicada en vientre y borde lateral de lengua. Se realizó biopsia y con el diagnóstico histopatológico de carcinoma escamocelular invasor bien diferenciado, se procedió a determinar la presencia del VPH y resultó positivo a VPH-16. Se realizó tratamiento oncológico combinado (quirúrgico-radiación-quimioterapia), con buenos resultados para la paciente respecto a la estética y función.

Conclusiones: se analizaron varios estudios que evalúan la presencia del VPH en lesiones de CECB, como un factor de riesgo que involucra con mayor frecuencia casos de pacientes jóvenes, la localización en lengua y antecedentes negativos para tabaquismo y alcoholismo frente a casos de CECB no asociados al VPH. Se requieren datos que contribuyan a dilucidar diversos aspectos aún desconocidos sobre la infección bucal por VPH y su relación con el CECB. 

Abstract

Background: Squamous cell cancer (SCC) represents 90- 95% of all types of cancer. In Mexico, the frequency of oral SCC (OSCC) has increased, with an incidence between 1 and 5%. OSCC is associated with subjects in the 5th and 7th decade of life, males, positive for smoking, alcoholism, genetic factors, immunosuppression, human papillomavirus (HPV) infection, and unhealthy lifestyles, among others. The objective of this work was to present a clinical case as an example of the emerging characteristics in a patient with OSCC.

Clinical case: 38-year-old female patient, with indurated ulcer, partially adhered to deep planes and painful, associated with an increase in volume, located on the belly and lateral edge of the tongue. A biopsy was performed and with the histopathological diagnosis of well differentiated invasive squamous cell carcinoma, the presence of HPV was determined, resulting positive for HPV-16. Combined cancer treatment was performed (surgical-radiation-chemotherapy), with good results for the patient regarding aesthetics and function.

Conclusions: We analyzed several studies evaluating the presence of HPV in lesions of OSCC, as a risk factor that involves more frequently cases of young patients, with location in tongue, and negative antecedents for smoking and alcoholism compared to cases of OSCC not associated with HPV. Data are required to help elucidate various still unknown aspects of oral HPV infection and its relationship with OSCC. 

 

 


Palabras clave


Neoplasias de la Boca; Factores de Riesgo; Virus del Papiloma Humano / Mouth Neoplasms; Risk Factors; Human Papillomavirus

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Referencias


 

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