Squamous Cell Carcinoma - Base of Tongue
- Also known as lingual tonsil squamous cell carcinoma (SCCa)
- Epithelial tumor of epidermoid origin arising in the lingual tonsilar area of the oropharyngeal mucosal space
- Lingual tonsils are part of the Waldeyer lymphatic ring located just posteriorly to the circumvallate papilla of the tongue
- Symptoms from this tumor occur late, so tumor is often large (>4 cm) at presentation
- Lesion can either be exophytic, invasive, or both
- Spread patterns:
- Anterior: sublingual space, oral tongue root, or floor of mouth
- Posteriolateral: anterior tonsillar pillar
- Inferior: supraglottic larynx and hypopharynx space
- On CT: Mucosal asymmetry and moderate enhancement with contrast, difficult to assess superficial spread, deep spread easily noted
- On MR: On T1 lesions are isointense to muscle and spread easily noted; on T2 lesions are iso- to hyperintese; post-contrast T1 shows enhancement
- Smoking and alcohol are known risk factors
- Most common nodal involvement is level II nodes
- Men and those over 40 are most commonly affected
- Lungs more so than bones more so than liver are the organs where metastasis is most commonly noted