Tongue cancer is one of the most common malignancies in the head and neck. It occurs as lesions or tumors develop due to the rapid proliferation of tongue-making cells. The tongue is one of the oral cavity’s most often affected subsites, along with the lip and the mouth’s floor.
Notably, the posterior third of the tongue base is considered a component of the oropharynx, whereas the front two-thirds are part of the oral cavity. A base of tongue malignancy differs from typical oral tongue cancer due to several significant outcomes while sharing similar histology.
Epidemiology
Traditionally, older adults with a history of smoking and consuming alcohol are more likely to acquire tongue cancer. The estimated prevalence of the disease varies significantly by geography, with a slight male preponderance. The prevalence of the disease had previously been steadily declining, probably due to a global decline in smoking.
However, studies indicate an alarming increase in cases of the base of the tongue and oral squamous cell carcinoma over the past few decades, particularly in younger patients and women without the usual risk factors of alcohol or cigarette use.
This is connected partly to the sharp increase in oropharyngeal squamous cell carcinomas linked to HPV. Additional genetic etiologic variables are being researched to help explain the disease’s shifting demographic composition.
Anatomy
Pathophysiology
The activation of oncogenes and suppression of tumor suppressor genes constitute oncogenesis. DNA damage results from lifetime exposure to recognized carcinogens in the oral cavity, and due to the accumulation of genetic events, carcinoma eventually develops.
Even though many genetic changes have been associated with the emergence of cancer, the connections between these genetic changes and their significance in carcinogenesis are still quite limited.
Mutations in the p53 tumor suppressor gene and overexpression of the epidermal growth factor receptor oncogene are two of the most well-known genetic changes that cause tongue cancer.
Etiology
Heavy smoking and alcohol use are the two most significant independent risk factors for the emergence of tongue malignancies. Smoke from cigarettes includes recognized carcinogens, primarily nitrosamines, and polycyclic hydrocarbons. Acetaldehyde, a product of alcohol metabolism, has an impact on DNA repair. Although less well documented, betel use, radiation exposure, immunocompromised conditions, poor oral hygiene, and hereditary factors are significant risk factors for the development of tongue cancer.
Infection with the human papillomavirus (HPV) has also been linked to tongue cancer. When compared to its HPV-negative equivalent, HPV-related cancer of the base of the tongue has lately been associated with a better response to therapy and improved survival. Experts in the subject are looking at therapy de-intensification methods to achieve a cure while avoiding adverse radiation effects in patients with HPV-positive malignancies of the base of the tongue and oropharynx.
In addition to the oral cavity, other areas of the head and neck have also been explored for this correlation between HPV-positive oropharyngeal malignancy and superior overall response. A definite, strong association has not yet been discovered, though. Therefore, unlike carcinoma of the base of the tongue, it does not appear that the presence or absence of HPV affects the course of therapy or prognosis for cancer of the tongue.
Genetics
Prognostic Factors
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
Future Trends
Media Gallary
References
www.ncbi.nlm.nih.gov/books/NBK562324/
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Tongue cancer is one of the most common malignancies in the head and neck. It occurs as lesions or tumors develop due to the rapid proliferation of tongue-making cells. The tongue is one of the oral cavity’s most often affected subsites, along with the lip and the mouth’s floor.
Notably, the posterior third of the tongue base is considered a component of the oropharynx, whereas the front two-thirds are part of the oral cavity. A base of tongue malignancy differs from typical oral tongue cancer due to several significant outcomes while sharing similar histology.
Traditionally, older adults with a history of smoking and consuming alcohol are more likely to acquire tongue cancer. The estimated prevalence of the disease varies significantly by geography, with a slight male preponderance. The prevalence of the disease had previously been steadily declining, probably due to a global decline in smoking.
However, studies indicate an alarming increase in cases of the base of the tongue and oral squamous cell carcinoma over the past few decades, particularly in younger patients and women without the usual risk factors of alcohol or cigarette use.
This is connected partly to the sharp increase in oropharyngeal squamous cell carcinomas linked to HPV. Additional genetic etiologic variables are being researched to help explain the disease’s shifting demographic composition.
The activation of oncogenes and suppression of tumor suppressor genes constitute oncogenesis. DNA damage results from lifetime exposure to recognized carcinogens in the oral cavity, and due to the accumulation of genetic events, carcinoma eventually develops.
Even though many genetic changes have been associated with the emergence of cancer, the connections between these genetic changes and their significance in carcinogenesis are still quite limited.
Mutations in the p53 tumor suppressor gene and overexpression of the epidermal growth factor receptor oncogene are two of the most well-known genetic changes that cause tongue cancer.
Heavy smoking and alcohol use are the two most significant independent risk factors for the emergence of tongue malignancies. Smoke from cigarettes includes recognized carcinogens, primarily nitrosamines, and polycyclic hydrocarbons. Acetaldehyde, a product of alcohol metabolism, has an impact on DNA repair. Although less well documented, betel use, radiation exposure, immunocompromised conditions, poor oral hygiene, and hereditary factors are significant risk factors for the development of tongue cancer.
Infection with the human papillomavirus (HPV) has also been linked to tongue cancer. When compared to its HPV-negative equivalent, HPV-related cancer of the base of the tongue has lately been associated with a better response to therapy and improved survival. Experts in the subject are looking at therapy de-intensification methods to achieve a cure while avoiding adverse radiation effects in patients with HPV-positive malignancies of the base of the tongue and oropharynx.
In addition to the oral cavity, other areas of the head and neck have also been explored for this correlation between HPV-positive oropharyngeal malignancy and superior overall response. A definite, strong association has not yet been discovered, though. Therefore, unlike carcinoma of the base of the tongue, it does not appear that the presence or absence of HPV affects the course of therapy or prognosis for cancer of the tongue.
www.ncbi.nlm.nih.gov/books/NBK562324/
medtigo
Tongue Cancer
Updated :
December 7, 2022
Tongue cancer is one of the most common malignancies in the head and neck. It occurs as lesions or tumors develop due to the rapid proliferation of tongue-making cells. The tongue is one of the oral cavity’s most often affected subsites, along with the lip and the mouth’s floor.
Notably, the posterior third of the tongue base is considered a component of the oropharynx, whereas the front two-thirds are part of the oral cavity. A base of tongue malignancy differs from typical oral tongue cancer due to several significant outcomes while sharing similar histology.
Traditionally, older adults with a history of smoking and consuming alcohol are more likely to acquire tongue cancer. The estimated prevalence of the disease varies significantly by geography, with a slight male preponderance. The prevalence of the disease had previously been steadily declining, probably due to a global decline in smoking.
However, studies indicate an alarming increase in cases of the base of the tongue and oral squamous cell carcinoma over the past few decades, particularly in younger patients and women without the usual risk factors of alcohol or cigarette use.
This is connected partly to the sharp increase in oropharyngeal squamous cell carcinomas linked to HPV. Additional genetic etiologic variables are being researched to help explain the disease’s shifting demographic composition.
The activation of oncogenes and suppression of tumor suppressor genes constitute oncogenesis. DNA damage results from lifetime exposure to recognized carcinogens in the oral cavity, and due to the accumulation of genetic events, carcinoma eventually develops.
Even though many genetic changes have been associated with the emergence of cancer, the connections between these genetic changes and their significance in carcinogenesis are still quite limited.
Mutations in the p53 tumor suppressor gene and overexpression of the epidermal growth factor receptor oncogene are two of the most well-known genetic changes that cause tongue cancer.
Heavy smoking and alcohol use are the two most significant independent risk factors for the emergence of tongue malignancies. Smoke from cigarettes includes recognized carcinogens, primarily nitrosamines, and polycyclic hydrocarbons. Acetaldehyde, a product of alcohol metabolism, has an impact on DNA repair. Although less well documented, betel use, radiation exposure, immunocompromised conditions, poor oral hygiene, and hereditary factors are significant risk factors for the development of tongue cancer.
Infection with the human papillomavirus (HPV) has also been linked to tongue cancer. When compared to its HPV-negative equivalent, HPV-related cancer of the base of the tongue has lately been associated with a better response to therapy and improved survival. Experts in the subject are looking at therapy de-intensification methods to achieve a cure while avoiding adverse radiation effects in patients with HPV-positive malignancies of the base of the tongue and oropharynx.
In addition to the oral cavity, other areas of the head and neck have also been explored for this correlation between HPV-positive oropharyngeal malignancy and superior overall response. A definite, strong association has not yet been discovered, though. Therefore, unlike carcinoma of the base of the tongue, it does not appear that the presence or absence of HPV affects the course of therapy or prognosis for cancer of the tongue.
www.ncbi.nlm.nih.gov/books/NBK562324/
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