Tongue Cancer

Determining the Type of Tongue Cancer

Only after a pathologist analyzes some cells or actual pieces of tissue from the lesion will your doctor be able to tell you if you have cancer. Your doctor and pathologist should specialize in oral cancers because some benign (non-cancerous) lesions can look like cancer on a small biopsy.

If you actually do have cancer, it will probably be squamous cell carcinoma.

  • Squamous cell carcinoma: This is a cancer that starts from abnormal cells on the surface layer of the lips or mouth lining. More than 85 percent of mouth cancers are squamous cell carcinomas.11, Kademani D. Oral cancer. Mayo Clinic proceedings. Mayo Clinic. Jul 2007;82(7):878-887.12Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head Neck. 2002 Feb;24(2):165-80.

Other epidermoid cancers (meaning cancers that start from the lining of the mouth) include:

  • Carcinoma in situ (also called severe dysplasia): This is really an early stage of squamous cell carcinoma. It is called carcinoma in situ when there are cancerous cells on the tissue lining the oral cavity but they have not invaded past the outermost layer of tissue. These should be removed completely, before they start invading (penetrating more deeply).
  • Verrucous carcinoma: This is a type of squamous cell carcinoma that has a better prognosis because it is less likely to spread. It should be treated as any other squamous cell carcinoma.

But there are other cancers that can start in the mouth, which include:

  • Salivary gland cancers: There are minor salivary glands located under the lining of the mouth. This is why cancers in this region can be glandular malignancies referred to as adenocarcinomas, including mucoepidermoid carcinomas, and adenoid cystic carcinomas. See Salivary Gland Cancer for more information. In rare instances, salivary gland cancers may grow inside the bone itself.
  • Lymphoma: The mouth also has lymphoid cells under the surface. This is why lymphoma could in rare cases appear as a lump in the mouth.
  • Mucosal melanoma: These cancers come from skin cells (melanocytes) that give skin its color. In rare cases, melanoma can be found in the lining of the mouth, nose and/or throat.
  • Kaposi’s sarcoma: This cancerous tumor is usually associated with AIDS. While it usually presents on the skin, it can be found with a similar appearance in the mouth. It looks like a purple lesion in the mouth filled with blood vessels.
  • Osteogenic sarcoma (also called osteosarcoma): This is a type of bone cancer that typically begins in the long bones of the arms and legs, though it can also occur very rarely in the jaw. It is the most common type of bone cancer among children and adolescents.

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12 Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT. Presentation, treatment, and outcome of oral cavity cancer: a National Cancer Data Base report. Head Neck. 2002 Feb;24(2):165-80.

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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

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