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Oral Tongue Squamous Cell Carcinoma - Radiology

last modified on: Tue, 04/09/2024 - 09:08

updated April 2024 by Piper Wenzel, BS

  • Squamous cell carcinoma (SCC) of the tongue is the most common SCC of the oral cavity (Matsuo et al. 2022)
  • Highly associated with smoking and alcohol use (Gonzalez et al. 2023)
  • Other risk factors include history of radiation exposure, poor oral hygiene, immunocompromised status, and HPV infection (Gonzalez et al. 2023)
  • Slight predominance in males and incidence increases with age (Matsuo et al. 2022)
  • Histologic features include "keratin deposits and nests of squamous cells with stromal fibrosis" (Gonzalez et al. 2022)
  • Some histologic subtypes include basaloid, spindle cell, verrucous, papillary, and acantholytic (Matsuo et al. 2022)
  • Advanced-stage carries a poor prognosis - 5-year survival around 50% (Gonzalez et al. 2023)
  • On CT: look for mandibular invasion on non-contrast; may variably enhance with contrast and tracking to the floor of the mouth may be observed
  • On MR: Low intensity on T1; high signal seen on T2; varible enhancement with T1 post-contrast, necrosis and rim-enhancment may be seen in large lesions
  • MRI is modality of choice prior to surgery due to non-ionizing radiation and "superior soft tissue contrast" (Rozendorn et al. 2022)

References

Matsuo K, Akiba J, Kusukawa J, Yano H. Squamous cell carcinoma of the tongue: subtypes and morphological features affecting prognosis. Am J Physiol Cell Physiol. 2022 Dec 1;323(6):C1611-C1623. doi: 10.1152/ajpcell.00098.2022. Epub 2022 Oct 17. PMID: 36252129.

Gonzalez M, Riera March A. Tongue Cancer. 2023 May 2. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan–. PMID: 32965995.

Rozendorn N, Greenberg G, Madgar O, Gluck I, Vered M, Alon E, Dobriyan A. Preoperative MRI for oral tongue squamous cell carcinoma: timing and correlation to histopathology. Int J Oral Maxillofac Surg. 2023 Mar;52(3):291-295. doi: 10.1016/j.ijom.2022.07.003. Epub 2022 Aug 8. PMID: 35953345.