Squamous cell carcinoma of tongue

2-3cm ulcerated and indurated lesion located in the left lateral tongue (arrow).

Infiltrative keratinizing well-differentiated squamous cell carcinoma of the tongue.  The presence of keratinization, intercellular bridges, and mild pleomorphism makes this lesion a well-differentiated SCC (left: low mag; right: high mag). Similar histological features are seen with squamous cell carcinoma of the larynx, especially the glottic lesions.

SCC of the tongue accounts for 20-25% of all malignant oral carcinomas. It typically affects older men in their 50-90s. Patients typically present with painless indurated or ulcerated lesions in the lateral aspect of anterior two thirds of tongue. Known etiologies include tobacco use, alcohol, and exposure to UV light. Other etiologies include trauma, nutritional deficiency, syphillis, and/or poor oral hygiene. SCC of the tongue initially metastasizes to the ipsilateral subdigastric lymph nodes. The prognosis and treatment depends on the histological grade of the lesion as well as the clinical staging (TNM classification), and the age of the patient. Treatment typically involves surgical resection with radiation therapy. 5-year survival rate is about 20-30%.