Early invasive squamous cell carcinoma arising from pemphigus vulgaris in the tongue: A case report

Abstract Background Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and oral mucous membrane. Tongue involvement occurs when most of the other common sites are concurrently affected or when the patient is in remission. PV is an autoimmune disease that may affect the invasive capacity of tongue tumors. An association between PV and cervical lymph node metastasis (CLNM) has been rarely reported in tongue cancer. Herein, we report a rare case of a 46-year-old man with early invasive squamous cell carcinoma (SCC) arising from PV of the tongue who presented with delayed CLNM. Case report A 46-year-old male was referred to our Department of Oral and Maxillofacial Surgery from the Department of Dermatology with a chief complaint of pain due to tongue erosion. The history of the patient revealed the presence of severe PV. A biopsy confirmed the diagnosis of concomitant PV with microinvasive SCC in the tongue. Despite a T1 stage tongue tumor, the patient developed delayed CLNM with extranodal extension two months after the primary surgery. Conclusion The present case underlines the association between PV, a chronic inflammatory disease of the oral cavity, and tongue SCC, and indicates the need for careful follow-up of patients with such inflammatory diseases. Furthermore, a biopsy should be performed in patients with PV of the tongue due to the potential for malignancy. Our findings indicate that PV may contribute to the invasion of SCCs and the promotion of lymph node metastasis.