Definition – What is squamous cell carcinoma of the tongue?
A squamous cell carcinoma is a malignant tumor or cancer. With the description squamous epithelium is meant the uppermost cell layer. This layer generally covers many external and internal surfaces in the body.
Cancer of the tongue can present itself in different forms. At the beginning of the disease there are usually no or few symptoms. Squamous cell carcinoma often develops at the edge and base of the tongue. It also spreads easily to the larynx.
What are the risk factors?
Risk factors leading to the development of squamous cell carcinoma include smoking, alcohol and poor oral hygiene. However, chronic mechanical factors, for example an ill-fitting prosthesis, can also be causally involved. Rather rare risk factors are previous infections with the human papilloma virus HPV or the condition after immunosuppression in organ transplanted patients. Thermal stimuli, i.e. the frequent consumption of very hot drinks or food, are also discussed. More information about the human papilloma virus: What is HPV?
Diagnosis
A first clue is obtained by the inspection, i.e. by looking at the changed area of the tongue. The examining doctor then palpates the suspicious area. Suspicious are those palpation findings that are of hard consistency and have little movement.
The jaw and neck area should also be palpated from the outside. Hardened lymph nodes can also be found here. This is followed by a biopsy, i.e. the removal of a small tissue sample, which is then examined in a high magnification (microscopy).
Since cancer cells have a completely different appearance than healthy cells under the microscope, the final diagnosis can be made here. It is then important to use an ultrasound probe to estimate how far the cancer has grown into the surrounding tissue. A more precise imaging should then also be carried out.
A CT or MRT are possible here. In case of bone pain, especially in the back, a PET-CT or bone scintigraphy should be performed. In general, tumor markers are not decisive for diagnosis, but rather represent progression parameters after diagnosis.
Thus, they are always based on the value measured for the first time. If this value increases during follow-up examinations after successful therapy, this is to be understood as an indication of a recurrence (recurrence of the cancer). Tumor markers are measured by taking a blood sample.
First the marker “CK-5” (cytokeratin 5) is determined. Since it is also positive for other types of cancer, it must be confirmed with the so-called “P40”. If both are positive, this is called a high predictive value. The presence of a squamous cell carcinoma of the tongue is therefore highly probable. However, it is not enough to determine the tumor markers to make a diagnosis.
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