Tongue cancer differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]

Overview

Tongue cancer must be differentiated from other diseases that cause malignant lesions of the oral cavity and from few non-neoplastic lesions of the oral cavity, such as lymphoma, adenoid cystic carcinoma, adenocarcinoma, mucoepidermoid carcinoma, rhabdomyosarcoma, liposarcoma, infections at the floor of mouth and mandible, and normal adenoid tissue for lesions at base of tongue.

Differential Diagnosis

The differential diagnosis for a squamous cell carcinoma of the tongue is essentially that of other malignant lesions of the oral cavity as well as a few non-neoplastic lesions. It includes the following:

• Other malignancy
  • Lymphoma
  • Minor salivary gland tumors
    • Adenoid cystic carcinoma
    • Adenocarcinoma
    • Mucoepidermoid carcinoma
  • Sarcoma
    • Rhabdomyosarcoma
    • Liposarcoma
• Infection: more a concern for floor of mouth lesions, or those with involvement of the mandible
• Normal adenoidal tissue: for base of tongue lesions

		Site	Clinical presentation		Investigations	Others
			Symptoms	Signs
Infections	Tuberculosis	Dorsum
	Scarlet fever
	Syphilis	Dorsum
Benign neoplasms	Papilloma	Dorsum and lateral borders
	Fibroma	Dorsum and lateral borders
	Rhabdomyoma
	Leiomyoma
	Schwannoma	Dorsum and lateral borders
	Neurofibroma	Dorsum and lateral borders
	Granular cell tumor
Malignant neoplasms	Squamous cell carcinotna
	Malignant salivary gland tumors	Ventral and dorsum
	Metastatic tumor
	Sarcoma
Idiopathic	Benign migratory glossitis	Dorsum
	Hairy tongue
Metablic	Diabetes mellitus
	Hypothyroidism
	Acromegaly
	Vitamin B deficiency	Dorsum	Redness in the tip and margins of the tongue Swelling of the tongue Indentations of the teeth Associated neurological symptoms due to niacin and B12 deficiency	Atrophy of both the filliform and fungiform papillae
	Amyloidosis	Lateral borders	Enlarged tongue Decrease in lingual mobility Difficulty in chewing, swallowing and speaking	Generalized induration Yellowish nodules

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