Tongue cancer classification

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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

There is no classification system established for tongue cancer. Nonsquamous cell cancers comprise fewer than 3% of all lingual malignancies. More than 90% of oral cavity cancers are squamous cell carcinomas. The majority of the other lesions are of minor salivary gland origin. Melanomas, lymphomas, and sarcomas rarely occur in the tongue.

Classification

There is no classification system established for tongue cancer. Approximately any malignancy can metastasize to the tongue. Statistically, carcinomas of the breast and malignancies of the lung, kidney, and adrenal gland are the most common malignancies which can metastasize to the tongue.

• Squamous cell carcinoma
  • More than 90% of oral cavity cancers are squamous cell carcinomas. The majority of the other lesions are of minor salivary gland origin. Melanomas, lymphomas, and sarcomas rarely occur in the tongue. Oral mucosal melanomas to the tongue are rare relative to other oral cavity sites such as the alveolar gingivae, palate, and lips. The two most prominent variants of oral squamous cell carcinomas that may be present are verrucous carcinoma and sarcomatoid squamous cell carcinoma.
• Verrucous carcinoma
  • Verrucous cell carcinomas is a unique form of squamous cell carcinoma related to human papillomavirus (HPV) infection. In the early phases of its growth, the tumor may be asymptomatic and subclinical as a verruciform growth phase that lasts several years. In other patients, the lesion may appear suddenly or as a slowly growing lesion that has a rapid and sudden growth phase.
• Sarcomatoid squamous cell carcinoma
  • Sarcomatoid carcinomas are also referred to as pseudosarcomatous squamous cell carcinoma, pseudosarcoma, metaplastic carcinoma, pleomorphic carcinoma, and the spindle variant of epidermoid carcinoma. The histogenesis of these tumors is not clear. The tumor manifests as a polypoid, rapidly growing, polypoid, and bulky mass, often in a site exposed to prior irradiation.
• Nonsquamous cell carcinoma
  • Nonsquamous cell cancers comprise fewer than 3% of all lingual malignancies. Malignancies of salivary gland origin may also occur, with mucoepidermoid carcinomas and adenoid cystic carcinomas predominating in histological subtypes. Relative to the palate, minor salivary gland malignancies of the tongue are rare.