Marijuana smoking as a possible cause of tongue carcinoma in young patients

A case report is presented in which the rare occurrence of tongue cancer in a young person is linked to habitual use of marijuana and tobacco. The 23-year-old man had an extremely painful cancer located on the tongue, but not extending to the floor of the mouth. The patient smoked 20 cigarettes per day, did not drink alcohol, and was a frequent marijuana smoker. Poor oral hygiene, untreated dental disease, other systemic conditions, and infections (such as syphilis) have previously been associated with tumors of the tongue, but were apparently not involved in this case. The patient had approximately half of his tongue removed (a hemiglossectomy), and the muscles, major veins and lymph nodes on both sides of his neck were dissected and removed ''en bloc'', known as a bilateral neck dissection. Despite this surgical course, and a review of the tissue by pathologists which showed containment of the disease within the removed tissues, the disease recurred approximately one year later. The patient was treated with radiotherapy, but the disease persisted in the area of the neck. While by itself one case does not point to marijuana as a cause, the medical literature suggests that marijuana use, perhaps potentiated by tobacco use, may be involved in the production of carcinoma. It is particularly unusual for a young person to experience tongue cancer, and this case is presented both to indicate a potential effect of the use of marijuana, and to point out the extremely aggressive nature of this disease. The authors believe that the course of treatment in this case may have been too conservative, and suggest that radiation therapy be used in all similar cases despite a finding of negative resection margins (when all the tumor is contained within the specimen removed). (Consumer Summary produced by Reliance Medical Information, Inc.)