Tongue cancer physical examination
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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] Mohammed Abdelwahed M.D[3]
Overview
Common physical examination findings of tongue cancer include otalgia, submandibular gland asymmetry, and cervical lymphadenopathy.
Physical Examination
- During the thorough physical examination the physician should check the roof and floor of your mouth, the back of your throat, the lymph nodes in your neck, the inside of the cheeks, the lips and the top, sides and underside of the tongue.
- Physician will be looking for red or white patches, lumps, swelling or any other unusual problems. A dental evaluation is also performed, with attention to dental hygiene, integrity of the mandible, and dentition status.[1]
Head
- During a complete head examination, specific attention is directed at the size and site of the lesion and infiltrating characteristics of the lesions.
- The physician should also perform a thorough bimanual examination of the tumor, the submandibular triangles, and the surrounding floor of mouth.
- Patients may present with red lesions, mixed red and white lesions, or white plaques.
- Extremely advanced cancers present as ulceroproliferative growths with areas of necrosis and extension to surrounding structures, such as bone, muscle and skin.
- In the terminal stages, patients may present with orocutaneous fistula, intractable bleeding, severe anaemia and cachexia.
- Cancer of the buccal mucosa may present as an ulcer with indurated raised margin, exophytic or verrucous growth or with the site of origin depending upon the preferential side of chewing and placement of betel quid.
- In advanced stages, these lesions infiltrate into the adjacent bone and overlying skin.
- Cancers of the floor of mouth may arise as a red area, a small ulcer or as a papillary lesion.
- Cancer of soft palate and uvula often appear as an ulcerative lesion with raised margins or as fungating masses.
- Cancer of the base of tongue presents late in the course of the disease as a grossly ulcerated, painful, indurated growth.[1]
Neck
- Submandibular gland asymmetry
- Cervical lymphadenopathy[1]
References
- ↑ 1.0 1.1 1.2 Stambuk HE, Karimi S, Lee N, Patel SG (2007). "Oral cavity and oropharynx tumors". Radiol Clin North Am. 45 (1): 1–20. doi:10.1016/j.rcl.2006.10.010. PMID 17157621.