Identifying tongue cancer through ulcers

A 33-year-old patient (residing in Lao Cai) was admitted to K Hospital (Hanoi) for treatment after suffering from tongue pain and ulcers for 4 months, with no improvement after applying topical medication.

At K Hospital, the patient was diagnosed with squamous cell carcinoma (a type of cancer that originates from the surface cells of the tongue) on the right edge of the tongue. The ulcerated mass on the right edge of the tongue measured 2 x 2.5 cm; the tumor size was 26 x 10 mm. The cancer had not metastasized to the lymph nodes and had not infiltrated adjacent areas.

Doctors at K Hospital perform reconstructive microsurgery on a patient after tongue cancer surgery.

PHOTO: THUY ANH

Dr. Ngo Xuan Quy, Head of the Head and Neck Surgery Department (K Hospital), stated: In tongue cancer, cancer cells respond poorly to radiotherapy or chemotherapy, so surgery plays a major role in treatment. In the case of the patient mentioned above, in addition to removing the tumor and the entire surrounding area, the surgeon also performed a right cervical lymph node dissection to thoroughly remove surrounding lymph nodes at risk of cancer cell metastasis, even when the lesion was not clearly visible on ultrasound images. For localized tongue cancer, if treated according to the correct protocol, the cure rate is very high: 70-80%.

However, the biggest challenge in tongue cancer surgery is its anatomical structure. The tongue has a complex vascular system and contains many important nerves that control taste, sensation, and movement. After removing half of the right tongue (in the case of the patient above), the patient faces the risk of a large defect in the oral cavity. If only conventional suture closure is used, the tongue will be severely contracted and deformed, causing the patient significant difficulty in eating and speaking.

Therefore, the doctors applied microsurgical reconstruction techniques – the most advanced technique in reconstructive surgery for patients. The doctors took a skin flap from the patient's arm to reconstruct the tongue. The flap was designed to fit perfectly, ensuring good speech and swallowing function, without affecting the airway or requiring a tracheostomy. Under a magnifying surgical microscope, the surgeons could observe the details and connect each tiny blood vessel and nerve fiber of the tissue flap to the blood vessels in the neck to nourish the newly reconstructed tongue. Five days after the successful surgery, the patient was able to eat and drink orally and converse quite well with those around them.

Tongue cancer is one of the most common malignant diseases in the oral cavity. In its early stages, the disease is easily mistaken for benign lesions such as canker sores or mouth ulcers.

When there are abnormalities in the tongue or oral cavity such as mouth ulcers, small bumps, or persistent ulcerated growths (lasting more than 2 weeks), it is necessary to go to a reputable medical facility for examination, proper diagnosis, and timely treatment. If it is cancer, early detection greatly affects the treatment outcome, according to K Hospital.

Source: https://thanhnien.vn/nhan-biet-ung-thu-luoi-qua-vet-loet-185260528190731941.htm