title: A rare case of extremely high counts of circulating tumor cells detected in a patient with an oral squamous cell carcinoma.
abstract: Despite aggressive regimens, the clinical outcome of head and neck squamous cell carcinoma remains poor. The detection of circulating tumor cells could potentially improve the management of patients with disseminated cancer, including diagnosis, treatment strategies, and surveillance. Currently, CellSearch(®) is the most widely used and the only Food and Drug Administration-cleared system for circulating tumor cells detection in patients with metastatic breast, colorectal, or prostate cancer. In most cases of head and neck squamous cell carcinoma, only low counts of circulating tumor cells have been reported.
  
  
  
  A 56-year-old white male with no particular medical history, was diagnosed with a squamous cell carcinoma of oral cavity. According to the imaging results (computed tomography and (18)F-fluorodeoxyglucose positron emission tomography / computed tomography) and panendoscopy, the TNM staging was classified as T4N2M0. A non-interruptive pelvimandibulectomy was conducted according to the multidisciplinary meeting advices and the postoperative observations were normal. The patient complained of a painful cervical edema and a trismus 6 weeks after the surgery. A relapse was found by computed tomography and the patient died two weeks later. The search for circulating tumor cells in peripheral venous blood by using the CellSearch(®) system revealed a very high count compared with published reports at three time points (pre-operative: 400; intra-operative: 150 and post-operative day 7: 1400 circulating tumor cells). Of note, all detected circulating tumor cells were epidermal growth factor receptor negative.
  
  
  
  We report here for the first time a rare case of oral squamous cell carcinoma with extremely high circulating tumor cells counts using the CellSearch(®) system. The absolute number of circulating tumor cells might predict a particular phase of cancer development as well as a poor survival, potentially contributing to a personalized healthcare.
authors.affiliation: Laboratory of Immunology, Nancytomique platform, CHRU of Nancy, rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France.|SBS Department, CRAN, UMR 7039 CNRS, University of Lorraine, Avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.|Department of Otorhinolaryngology - Head and Neck surgery, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, 430071, Wuhan, China.
authors.forename: Xianglei
authors.initials: X
authors.lastname: Wu
authors.affiliation: SBS Department, CRAN, UMR 7039 CNRS, University of Lorraine, Avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.|Head and Neck Surgery and Dental Units, Oncologic Surgery Department, Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54500, Vandœuvre-lès-Nancy, France.
authors.forename: Romina
authors.initials: R
authors.lastname: Mastronicola
authors.affiliation: Laboratory of Immunology, Nancytomique platform, CHRU of Nancy, rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France.|SBS Department, CRAN, UMR 7039 CNRS, University of Lorraine, Avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.
authors.forename: Qian
authors.initials: Q
authors.lastname: Tu
authors.affiliation: Laboratory of Immunology, Nancytomique platform, CHRU of Nancy, rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France.|SBS Department, CRAN, UMR 7039 CNRS, University of Lorraine, Avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.
authors.forename: Gilbert Charles
authors.initials: GC
authors.lastname: Faure
authors.affiliation: Laboratory of Immunology, Nancytomique platform, CHRU of Nancy, rue du Morvan, 54500, Vandoeuvre-lès-Nancy, France. marcelo.decarvalho@univ-lorraine.fr.|SBS Department, CRAN, UMR 7039 CNRS, University of Lorraine, Avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France. marcelo.decarvalho@univ-lorraine.fr.
authors.forename: Marcelo
authors.identifier: 0000-0002-2698-2458
authors.initials: M
authors.lastname: De Carvalho Bittencourt
authors.affiliation: SBS Department, CRAN, UMR 7039 CNRS, University of Lorraine, Avenue de la Forêt de Haye, 54500, Vandoeuvre-lès-Nancy, France.|Head and Neck Surgery and Dental Units, Oncologic Surgery Department, Institut de Cancérologie de Lorraine, 6 Avenue de Bourgogne, 54500, Vandœuvre-lès-Nancy, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dolivet
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000601:surgery*; D017809:Fatal Outcome; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D012008:Recurrence
chemical_list: D019788:Fluorodeoxyglucose F18
keywords: Circulating tumor cells; Head and neck squamous cell carcinoma; Oral squamous cell carcinoma; Survival