Squamous cell carcinoma of the tongue after bone marrow transplant and graft-versus-host disease: a case report and review of the literature.

Allogenic bone marrow transplantation (BMT) is a curative therapy for malignant and nonmalignant lymphohematopoietic diseases and other disorders. However, the development of secondary malignancies is an important complication among transplantation survivors. Patients who have undergone BMT have a 2to 8-fold higher risk of developing these cancers than the general population. After BMT, the most common secondary malignancies, such as lymphoma or leukemia, arise in hematopoietic tissue. Moreover, these hematologic secondary malignancies develop relatively early during the post-transplantation period. However, though uncommon, secondary solid tumors, like squamous cell carcinoma (SCC), are also associated with BMT, and their incidences appear to increase with time. Potential risk factors associated with the development of secondary cancers after BMT have been well described and include chronic graft-versus-host disease (GVHD), prolonged immunosuppressive therapy, pretransplantation radiation and chemotherapy, antigen stimulation arising from histocompatibility differences between recipient and donor, and other factors such as oncogenic virus infection. In this report, we describe a young patient with SCC of the tongue associated with chronic oral GVHD and human papillomavirus (HPV) infection after allogenic BMT.