Tumor of the tongue
tongue cancer surgery
cancer surgery
maxillofacial oncological surgery
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Tumor of the tongue
Tumor of the tongue - Oncological surgery
Introduction to the tumor of the tongue
The tongue tumor is part of the tumors of the mouth.
This tumor can be classified according to its location:
- anterior portion corresponding to the mobile part of the tongue.
- back portion or base of the tongue.
Tongue tumors for 70% of cases are localized in the posterior portion.
From an epidemiological point of view, the tumor of the tongue has an incidence of about 8-10 cases per 100,000 inhabitants.
The maximum frequency of the tongue tumor usually occurs around the 6th decade even if lately we are witnessing an increase in cases that occur at a younger age. The male ratio: females is 3: 1.
The factors that predispose to the onset and the modalities of presentation of the tumor of the tongue are the same ones described for the tumor of the mouth.
Symptoms of the tumor of the tongue
The tongue tumor may present (as for the tumor of the mouth) as a red spot (erythroplakia) or as a white spot (leukoplakia); at other times it may present itself in the form of an injury that does not heal and which can cause blood to escape from the oral cavity.
Often during mastication or swallowing appears a mild or moderate pain, sometimes also mistaken for a sore throat. Finally we can have alterations of the breath with halitosis (bad breath) or bad taste in the throat.
Diagnosis of the tumor of the tongue
The tumor of the tongue should be suspected whenever there is a lesion of the tongue as explained above.
When this injury is highlighted, it is essential that the patient is referred to the maxillofacial specialist to make a diagnosis of certainty.
The only tool capable of diagnosing certainty in a tongue tumor is biopsy. This is usually conducted under local anesthesia by the surgeon and allows us to make the diagnosis.
Secondly, it will be necessary to carry out a diagnostic investigation using MRI with and without contrast to evaluate which and how many of the surrounding tissues are involved and to evaluate the situation of the lymph nodes in the neck. If the tumor of the tongue extends to involve a bone structure, it will be necessary to perform a CT scan with and without contrast.
Histology of the tumor of the tongue
Histologically, 95% of the tumors of the tongue is a spino-cell carcinoma that can present itself as well differentiated until poorly differentiated depending on the degree of cellular atypia present.
More rarely, cases of lymphomas, anaplastic tumor, adenoidocystic carcinoma and adenocarcinoma can occur.
Language tumor therapy
Therapy of the tumor of the tongue can not disregard the staging of the tumor itself according to the TNM classification (described in the tumor of the mouth).
The therapy of the tumor to the tongue is surgical and foresees the removal of the portion involved from the neoplasm and of a healthy margin that surrounds it. The resection of the lingual neoplasm is associated with laterocervical depletion.
In case the surgical treatment has not been radical or in cases where this can not be performed or in the case of metastases at the locoregional lymph nodes, neoadjuvant / adjuvant radiotherapy is one of the multimodal treatments associated in selected cases to chemotherapy.
Complications of language tumor therapy
In addition to the common complications of surgery (eg infections and bleeding), the removal of a portion of the tongue with a possible micro-vascular reconstruction can lead to immediate post-operative problems related to the vitality of the flap and edema of the pharyngeal region. These factors can impair breathing and cause difficulty in swallowing, talking and eating.
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