Posters
« Back
133:Geographic Tongue and Oral Dysesthesia Associated With Sunitinib: A Case Report[AAOM2021}
EP36135
Poster Title: 133:Geographic Tongue and Oral Dysesthesia Associated With Sunitinib: A Case Report[AAOM2021}
Submitted on 17 Apr 2021
Author(s): Alphonse Jimmy, Ruchi Trambadia, Caroline Hanna, Chizobam Idahosa, BDS, DDS, MS
Affiliations: Department of Oral and Maxillofacial Pathology, Medicine and Surgery Temple University Maurice H. Kornberg School of Dentistry, Philadelphia, PA
This poster was presented at 2021 American Academy of Oral Medicine Virtual Conference
Poster Views: 175
View poster »


Poster Information
Abstract: Abstract: Background:

Recent advances in cancer chemotherapy have resulted in the development of target-specific antineoplastic agents. Oral adverse events (OAEs) have been reported in patients treated with angiogenesis inhibitors and VEGFR-directed multitargeted tyrosine kinase inhibitors (TKIs). We describe a patient who presented with geographic tongue and other OAEs in association with Sunitinib.

Case Summary:

A 54-year-old female presented with chief concern of “I have burning mouth and geographic tongue issues.” She also complained of dry mouth. Her symptoms started one month after initiation of Sunitinib for left eye choroidal malignant melanoma and had been ongoing for four months. She denied prior history of geographic tongue. The burning was severe and constant, involving her tongue, palate and lips and although she reported chronic dry mouth, it significantly intensified with Sunitinib. For her symptoms, she had been on 0.5mg Clonazepam wafer at bedtime, Dexamethasone elixir and magic mouth wash with minimal benefit. She reported an extensive past medical history including Sjogren’s syndrome diagnosed a year prior, rheumatoid arthritis, type 2 diabetes with HbA1c of 5.9, anxiety, depression, glaucoma and choroidal malignant melanoma. Upon intraoral examination, her tongue presented with white serpiginous keratotic lines surrounding smooth patches of depapillation consistent with geographic tongue and the oral mucosa was dry. Although she had multiple co-morbid conditions, based on the timeline of her symptoms, a working diagnosis of Sunitinib-induced oral dysesthesia and geographic tongue was made. She was advised to continue her current regimen and given extensive instructions including bland diet, cryotherapy, increased hydration, saliva substitutes and xylitol gum. Gabapentin 100mg was initiated but soon discontinued due to sedation. At her three-month follow-up visit, she reported discontinuing Sunitinib a month prior. Her oral discomfort had significantly decreased. The geographic tongue was less prominent, the burning was almost gone and although her mouth was still dry, there was marked improvement.

Conclusions:

Patients on TKIs may present with self-limiting OAEs including geographic tongue, oral dysesthesia and xerostomia. Oral health-care providers should be aware of these potential side effects. Patients with asymptomatic lesions need reassurance. In addition, those with symptomatic lesions require the implementation of a comprehensive management plan.
Summary: Recent advances in cancer chemotherapy have resulted in the development of target-specific antineoplastic agents. Oral adverse events (OAEs) have been reported in patients treated with angiogenesis inhibitors and VEGFR-directed multitargeted tyrosine kinase inhibitors (TKIs). We describe a patient who presented with geographic tongue and other OAEs in association with Sunitinib.

Ask the author questions about this poster:cidahosa@temple.edu

References: References: 1. Arena C, Troiano G, Lillo AD, Testa NF, Muzio LL. Stomatitis and VEGFRTyrosine
Kinase Inhibitors (VR-TKIs): A Review of Current Literature in
4369 Patients. BioMed Research International. 2018;2018:1-16.
doi:10.1155/2018/5035217.
2. Sundar S, Burge F. Geographical tongue induced by axitinib. BMJ Case
Reports. 2015.doi:10.1136/bcr-2015-211318.
3. Vigarios E, Epstein JB, Sibaud V. Oral mucosal changes induced by
anticancer targeted therapies and immune checkpoint inhibitors.
Supportive Care in Cancer. 2017;25(5):1713-1739.doi:10.1007/s00520-
017-3629-4.
4.. Hubiche T, Valenza B, Chevreau C, Fricain J-C, Giudice PD, Sibaud V.
Geographic Tongue Induced by Angiogenesis Inhibitors. The Oncologist.
2013;18(4).doi:10.1634/theoncologist.2012-0320.
Report abuse »
Creative Commons