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Head and Neck Imaging

Tongue cancer

Nearly all cancers of the oral tongue are squamous cell carcinoma head and neck. Tumours arising from the anterior part are usually seen in an early stage as a superficial lesion. More posteriorly located lesions may be deeply infiltrating at presentation; there is no barrier within the tongue to restrict their spread. Posterior spread to the oropharynx (along the anterior tonsillar pillar) and further inferior spread to the sublingual space and remainder of the floor of the mouth is possible. Lateral extension to the mandible is seen in bulky tumours; mandibular invasion usually occurs via the dental sockets. The first-order lymph nodes are the submandibular and high parajugular groups (level I and II, see level system of lymph node classification).

CT and MRI is very useful for studying the deep spread of these cancers; determining the extent of tongue neoplasms is critical in planning surgery and/or radiation therapy.

For cancer of the tongue base, see oropharynx cancer.

RH