High-Grade Mucoepidermoid Carcinoma with Sarcomatous Features of the Tongue in a Seven-Year-Old Boy: A Case Report

Abstract

Objective: To report an unusually aggressive presentation of high-grade mucoepidermoid carcinoma (MEC) with sarcomatous features of the tongue base in a seven-year-old boy, characterized by early recurrence, rapid progression and poor response to treatment.

Methods:
Design: Case Report
Setting: Tertiary Government Training Hospital
Patient: One

Results: A seven-year-old boy presented with a left tongue base mass that rapidly enlarged with associated dysphagia and weight loss. Biopsy of the pedunculated mass attached to the left tongue base, abutting the anterolateral tongue, revealed high-grade MEC. Following left subtotal glossectomy with radical neck dissection, histopathology confirmed high-grade MEC with sarcomatous features with negative margins but positive lymph nodes. Post-operative recurrent masses were twice excised at three weeks (left tonsil) and another 12 days (oropharynx extending to neck). Despite tumor debulking and three radiotherapy sessions, the residual mass enlarged further and metastasized to the lungs and liver six weeks postoperatively. The patient’s condition further deteriorated and he expired prior to starting chemotherapy.

Conclusion: High-grade MEC of the tongue base is exceedingly rare in children. This case exhibited sarcomatous features and demonstrated unusually aggressive behavior characterized by early recurrence, rapid progression, and poor response to treatment. Continued reporting of such rare presentations is vital to augment knowledge of pediatric MEC with sarcomatous features.