Updated by Piper Wenzel, BS May 2024
- Also known as lingual tonsil squamous cell carcinoma (SCCa)
- The posterior third of the tongue is referred to as the base of the tongue and considered part of the oropharynx (Gonzales 2023)
- Lingual tonsils are part of the Waldeyer lymphatic ring located just posteriorly to the circumvallate papilla of the tongue (Arambula 2021)
- Smoking and alcohol use are known risk factors as well as HPV (Gonzales 2023)
- HPV-positive carcinoma has been associated with better response to therapy and survival compared to HPV-negative tumors (Gonzales 2023)
- Histopathological features include "keratin deposits and nests of squamous cells with stromal fibrosis" (Gonzales 2023)
- Metastasis most commonly occurs in the lungs, bone, and liver (Montagne 2023)
- 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 hyperintense; post-contrast T1 shows enhancement
References
Arambula A, Brown JR, Neff L. Anatomy and physiology of the palatine tonsils, adenoids, and lingual tonsils. World J Otorhinolaryngol Head Neck Surg. 2021;7(3):155-160. Published 2021 Jun 27. doi:10.1016/j.wjorl.2021.04.003
Gonzalez M, Riera March A. Tongue Cancer. [Updated 2023 May 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK56232
Montagne W, Thi W, Lee L, Okuyemi OT, Wang RC. Base of Tongue Squamous Cell Carcinoma With Metastasis to the Mandibular Symphysis: A Case Report. Cureus. 2023;15(12):e50417. Published 2023 Dec 12. doi:10.7759/cureus.50417