Surgery>>>>>Disorders of the Head and Neck
Question 3#

Features of oral tongue carcinoma include all of the following EXCEPT:

a. Presentation as ulcerated exophytic mass
b. May involve submandibular and upper cervical lymph nodes
c. Can result in contralateral paresthesias
d. CO2 laser useful for excision of small early tumors

Correct Answer is C


Tumors of the tongue begin in the stratified epithelium of the surface and eventually invade into the deeper muscular structures. The tumors may present as ulcerations or as exophytic masses. The regional lymphatics of the oral cavity are to the submandibular space and the upper cervical lymph nodes. The lingual nerve and the hypoglossal nerve may be directly invaded by locally extensive tumors. Involvement can result in ipsilateral paresthesias and deviation of the tongue on protrusion with fasciculations and eventual atrophy. Tumors on the tongue may occur on any surface, but are most commonly seen on the lateral and ventral surfaces. Primary tumors of the mesenchymal components of the tongue include leiomyomas, leiomyosarcomas, rhabdomyosarcomas, and neurofibromas. Surgical treatment of small (Tl -T2) primary tumors is wide local excision with either primary closure or healing by secondary intention. The CO2 laser may be used for excision.