Sideroblastic anemia as the first presentation of squamous cell tongue carcinoma
A 60 year-old man was admitted to our department because
of progressive weakness and a 10 kilogram weight loss during
the previous 2 months. The patient was a tobacco and
alcohol abuser and had no previous hospital admissions.
Physical examination revealed anemia and hand flapping.
Laboratory exams revealed anemia (Ht=24%, Hb=7,9g/dl),
decreased reticulocytes (25.000/mm3), elevated serum ferritin
(1390ng/ml) and increased transaminase levels. Bone
marrow biopsy revealed sideroblasts, maturation abnormalities
of the red row and infiltration of malignant cells unknown
origin. Further investigation revealed a well differentiated,
very small in size, squamous cell carcinoma of
the tongue. We discuss the role of alcohol and tobacco abuse
in relation to oral cavity malignacies and to sideroblastic
anemia. To the best of our knowledge it is the first case of
tongue carcinoma presenting with sideroblastic anemia.
Key words: squamous cell tongue carcinoma, sideroblastic
anemia, bone marrow infiltration, alcohol, tobacco.