Outcome and follow-up
Patient follow-up is favorable, at 18 months, the patient showed no recurrence and new erosive lesions appeared on the left lateral border of the tongue, but the biopsy did not show epithelial dysplasia (Figure 3A and 3B). At 6 years, a new biopsy concluded that there was no malignancy. The last follow-up appointment in February 2021 indicates that the clinical examination of the mucosa and lymph nodes is completely satisfactory.
The reported case shows that pregnant women may have tongue SCC, even if rarely, can be associated with a potentially malignant lesion such as OLP. The hypothesis of disruption of the patient’s immune system, linked to her pregnancy or a possible activation of oncogenic viruses, could explain the transformation of OLP into SCC, but more investigation for proving association with hormonal modification during pregnancy is needed. It is important to focus on early detection and early intervention for pregnant women with a regular oral examination, especially of the tongue, to detect early signs of cancer. All areas of suspected oral inflammatory mucosa or potentially malignant lesions OLP-like should be biopsied and monitored with regularity to exclude malignancy. The practitioner must inform the patient of the potential risk of transformation of the OLP.