Close

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.

19_tongue

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

1 National Cancer Institute. SEER Database. SEER Stat Fact Sheets. http://seer.cancer.gov/statfacts/html/tongue.html . Accessed January 25, 2012.

2 Petersen PE. Oral cancer prevention and control – The approach of the World Health Organization, Oral Oncol. 2008.

3 Ko YC, Huang YL, Lee CH, Chen MJ, Lin LM, Tsai CC. Betel quid chewing, cigarette smoking and alcohol consumption related to oral cancer in Taiwan. Journal of oral pathology & medicine: official publication of the International Association of Oral Pathologists and the American Academy of Oral Pathology. Nov 1995;24(10):450-453.

4 Shugars DC, Patton LL. Detecting, diagnosing, and preventing oral cancer. The Nurse Practitioner. Jun 1997;22(6):105,109-110,113-105 passim.

5 Neville BW, Day TA. Oral cancer and precancerous lesions. CA: a cancer journal for clinicians. Jul-Aug 2002;52(4):195-215.

6 Spiro RH, Thaler HT, Hicks WF, Kher UA, Huvos AH, Strong EW. The importance of clinical staging of minor salivary gland carcinoma. Am J Surg. 1991 Oct;162(4):330-6.

7 Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol.1993;11:1751-6.

8 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010 Mar 10;28(8):1395-400.

9 Koch WM, Choti MA, Civelek AC, Eisele DW, Saunders JR. Gamma probe-directed biopsy of the sentinel node in oral squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 1998. 124:455-9.

10 Shoaib T, Soutar DS, MacDonald DG, Camilleri IG, Dunaway DJ, Gray HW, McCurrach GM, Bessent RG, MacLeod TIF, Robertson AG. The accuracy of head and neck carcinoma sentinel lymph node biopsy in the clinically N0 neck. Cancer. 2001;91:2077-2083.

11 Kademani D. Oral cancer. Mayo Clinic proceedings. Mayo Clinic. Jul 2007;82(7):878-887.

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.

13 Kraus FT, Perezmesa C. Verrucous carcinoma. Clinical and pathologic study of 105 cases involving oral cavity, larynx and genitalia. Cancer. Jan 1966;19(1):26-38.

14 Listl S, Jansen L, Stenzinger A, Freier K, Emrich K, et al. Survival of patients with oral cavity Cancer in Germany. PLoS ONE. 2013;8(1):e53415.

15 Anneroth G, Batsakis J, Luna M. Review of the literature and a recommended system of malignancy grading in oral squamous cell carcinomas. Scand J Dent Res. 1987;95;229-249.

16 Edge SB, et al. The AJCC Cancer Staging Manual – Seventh Edition. American Joint Committee on Cancer 2010.

17 Jan JC, Hsu WH, Liu SA, Wong YK, Poon CK, Jiang RS, Jan JS, Chen IF. Prognostic factors in patients with buccal squamous cell carcinoma: 10-year experience. J Oral Maxillofac Surg. 2011 Feb;69(2):396-404.

18 Pradhan SA, Rajpal RM. Marginal mandibulectomy in the management of squamous cancer of the oral cavity. Indian J Cancer. 1987;24;167-171.

19 Pentenero M, Gandolfo S, Carrozzo M. Importance of tumor thickness and depth of invasion in nodal involvement and prognosis of oral squamous cell carcinoma: a review of the literature. Head Neck. 2005 Dec;27(12):1080-91.

20 Maddox WA, Urist MM. Histopathological prognostic factors of certain primary oral cavity cancers. 1990 Dec;4(12):39-42; discussion 42,45-6.

21 Urist MM, O'Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987 Oct;154(4):411-4.

22 Piccirillo JF, Costas I, Reichman ME. Chapter 2: Cancers of the head and neck.Ries LAG, Young JL, Keel GE, Eisner MP, Lin YD, Horner M-J (editors). SEER Survival Monograph: Cancer Survival Among Adults: U.S. SEER Program, 1988-2001, Patient and Tumor Characteristics. National Cancer Institute, SEER Program, NIH Pub. No. 07-6215, Bethesda, MD, 2007.

23 Adelstein, D. J., et al. (2012). "Transoral resection of pharyngeal cancer: summary of a National Cancer Institute Head and Neck Cancer Steering Committee Clinical Trials Planning Meeting, November 6-7, 2011, Arlington, Virginia." Head Neck 34(12): 1681-1703.

24 Byers, R. M. (1991). "Neck dissection: concepts, controversies, and technique." Semin Surg Oncol 7(1): 9-13.

25 Hinni, M. L., et al. (2013). "Margin mapping in transoral surgery for head and neck cancer." Laryngoscope 123(5): 1190-1198.

26 Cracchiolo, J. R., et al. (2016). "Increase in primary surgical treatment of T1 and T2 oropharyngeal squamous cell carcinoma and rates of adverse pathologic features: National Cancer Data Base." Cancer 122(10): 1523-1532.

27 Denis, F., et al. (2004). "Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma." J Clin Oncol 22(1): 69-76.

28 Zumsteg, Z. S., et al. (2017). "Impact of concomitant chemoradiation on survival for patients with T1-2N1 head and neck cancer." Cancer 123(9): 1555-1565.

29 Sher, D. J., et al. (2017). "Radiation therapy for oropharyngeal squamous cell carcinoma: Executive summary of an ASTRO Evidence-Based Clinical Practice Guideline." Pract Radiat Oncol 7(4): 246-253.

30 Haughey, B. H., et al. (2011). "Transoral laser microsurgery as primary treatment for advanced-stage oropharyngeal cancer: a United States multicenter study." Head Neck 33(12): 1683-1694.

31 Cohen, E. E., LaMonte, S. J., Erb, N. L., Beckman, K. L., Sadeghi, N. , Hutcheson, K. A., Stubblefield, M. D., Abbott, D. M., Fisher, P. S., Stein, K. D., Lyman, G. H. and Pratt‐Chapman, M. L. (2016), American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA: A Cancer Journal for Clinicians, 66: 203-239. doi:10.3322/caac.21343

Important: Privacy Update

Your privacy and the protection of your personal information is important to the THANC (Thyroid, Head and Neck Cancer) Foundation and the Head & Neck Cancer Guide (HNCG). For this reason, we have updated our privacy policy to align with the GDPR (General Data Protection Regulation).

Please click below to see an updated privacy policy that describes how we collect and use your personal information and respect your privacy.

Privacy Policy