Tongue Carcinoma in Immunosuppressed Patients After Liver and Kidney Transplantation: A Case Series

BACKGROUND Solid organ transplant recipients carry an elevated risk of de novo malignancies under chronic immunosuppression, including aggressive squamous cell carcinoma (SCC) of the oral cavity and oropharynx. Practical, evidence-based guidance for maxillofacial management in this population remains limited. CASE REPORT Case 1 involved a 44-year-old man who developed T1N0 SCC of the lateral tongue 23 months after orthotopic liver transplantation for alcoholic cirrhosis. He was treated with partial glossectomy and selective neck dissection, followed by re-excision for a positive deep margin; he remains disease-free at 2 years, with mild residual tongue hypomobility. Case 2 involved a 59-year-old man who developed T2N1M0 SCC of the tongue 8 months after kidney transplantation. He underwent extended hemiglossectomy with neck dissection, anterolateral thigh free flap reconstruction, and adjuvant chemoradiotherapy; suspected locoregional recurrence required limited resection, and he remains disease-free at 5 years. Case 3 involved a 62-year-old woman who developed T1N0M0 SCC of the floor of the mouth 12 years after liver transplantation. She was treated via local excision followed by block neck dissection without adjuvant therapy and remains disease-free at 1 year, with preserved function. CONCLUSIONS Oral SCC in transplant recipients can arise early or late after transplantation and requires meticulous surgical clearance, judicious use of adjuvant therapy, and vigilant surveillance. Close multidisciplinary coordination with transplant teams to optimize and, when feasible, de-escalate immunosuppression is essential, along with routine oral cancer screening and risk factor modification. Larger multicenter studies are needed to refine screening intervals and peri-oncologic immunosuppressive strategies.