Doxorubicin induced tongue hyperpigmentation

Abstract

Oral hyperpigmentation is an infrequent phenomenon reported in the literature as a side effect that may be seen with the administration of certain chemotherapy agents such as doxorubicin. Given the under reported nature of mucosal hyperpigmentation, treating providers are frequently unaware of this benign presentation and thus may pursue unnecessary testing. The exact pathophysiology and mechanism of action of this phenomenon is poorly understood; however, it is hypothesized that some chemotherapy drugs may trigger increased melanin deposition. With regard to management, clinical monitoring for eventual resolution status post chemotherapy without additional therapy is sufficient. Increased familiarity with this uncommon side effect will prevent invasive testing and undue stress to the patient. We present a case of tongue hyperpigmentation that occurred during administration of doxorubicin and cyclophosphamide in the neoadjuvant setting for management of stage IIIA(cT2,cN1,M0) hormone receptor positive breast cancer, which resolved without intervention after completion of chemotherapy course.

Keywords

• Hyperpigmentation
• Chemotherapy adverse events
• Breast cancer
• Case report