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Tongue Cancer

Understanding the Anatomy

The tongue is a thick and muscular organ. The tongue is broken down into two main parts, the oral tongue and the base of tongue. These parts are divided by the circumvallate papillae.

  • Oral tongue: This is the front two-thirds of the tongue—the part of the tongue that you can see when you open your mouth. This part of the tongue is in the oral cavity.
  • Base of tongue: This part of the tongue is actually part of the oropharynx, which is part of the throat. The base of tongue is not part of the oral cavity. You can’t see the base of tongue just by looking in your mouth, but you can feel it if you slide your finger all the way back.

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The oral tongue has a few parts to it as well:

  • Tip: This is the front part of the tongue.
  • Lateral border: This is the side of the tongue. There is a right lateral border and a left lateral border.
  • Dorsal surface: This is the top surface of the tongue, which is closest to the roof of the mouth.
  • Ventral surface: This is the undersurface of the tongue. It is continuous with the floor of mouth.

The tongue is covered by a lining of mucosa, but the rest of it is muscle. Most cancers of the tongue start in this outer lining of the tongue. The lining of the tongue is continuous with the lining of other subsites of the oral cavity, particularly the floor of mouth, the retromolar trigone and the anterior tonsillar pillar. That is why a cancer that starts in the tongue might extend to other subsites of the oral cavity as well.

The muscles of the tongue are divided into extrinsic muscles of the tongue and intrinsic muscles of the tongue.

  • Extrinsic muscles of the tongue: These are muscles that start from some structure in the face or neck outside of the tongue. These are responsible for moving the tongue around the mouth in different directions.
  • Intrinsic muscles of the tongue: These muscles are completely within the tongue. They are responsible for changing the shape of the tongue. Some people have more control of these muscles than others, such as those who can curl their tongues.

In addition to a few other factors, tongue cancers should be described by their location on the tongue, what other subsites they extend to, how much of the tongue is involved and how deeply they invade into the muscles of the tongue.

References

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17 Referenced with permission from The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Head and Neck Cancers V.2.2016. © National Comprehensive Cancer Network, Inc 2016. All rights reserved. Accessed November 9, 2016. To view the most recent and complete version of the guideline, go online to www.NCCN.org.

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