Abstract

Background: Squamous cell carcinoma (SCC) is the most common form of cancer in the oral cavity and oropharynx. Early detection is amongst the most crucial factors for effective treatment and disease-free survival. Recent studies have explored potential prognostic indicators and screening markers, such as β-hCG antibody, to enhance clinical decision-making and prioritize therapeutics. β-hCG levels have been found to be associated with poorer outcomes and shorter survival time in various carcinomas, including oral squamous cell cancer. Case Presentation: This case uniquely presents a 47-year-old woman with a poorly differentiated squamous cell carcinoma of the oral tongue. The patient presented with a large bleeding tumor, bilateral hypoglossal nerve weakness, lymphadenopathy, and dysarthric speech. Despite a history of bilateral tubal ligation, the patient tested positive for pregnancy due to ectopic β-hCG secretion by the tumor. Biopsy confirmed the diagnosis of invasive oral squamous cell carcinoma with increased serum levels of β-hCG. Palliative immunotherapy was initiated due to the advanced stage of the tumor, and tracheostomy and percutaneous endoscopic gastrostomy were performed to maintain the patient's airway and nutrition during treatment. Conclusion: This case report highlights the potential use of β-hCG as a prognostic indicator for oral squamous cell carcinomas. Further research is needed to establish the relationship between β-hCG secretion and tumor growth rate, as well as to determine threshold levels, and possible eventual incorporation into guidelines. Utilizing β-hCG as a clinical tumor marker could represent a novel method to diagnose, monitor treatment, and surveil for recurrence. Evaluation of salivary and serum levels of β-hCG should also be considered in future studies to explore their potential clinical significance. Lastly, given the advanced stage at presentation in this case our study advocates for increased screening and education on the signs, symptoms, and risks for oral cancer.