Styloglossus muscle cancer is a rare form of malignant soft tissue tumor that arises from or invades the styloglossus muscle, one of the extrinsic muscles of the tongue. In most cases, it represents a rhabdomyosarcoma—a cancer of skeletal muscle origin—occurring either as a primary tumor within the styloglossus or by direct extension from adjacent tongue lesions PMCMayo Clinic.
Anatomy of the Styloglossus Muscle
An understanding of the normal anatomy of the styloglossus is crucial to appreciating how cancer affects its function and surrounding structures.
-
Structure & Location
-
A thin, paired muscle lying on either side of the oropharynx, deep to the hyoglossus.
-
Forms part of the extrinsic tongue muscles that alter tongue position for speech and swallowing Radiopaedia.
-
-
Origin
-
Arises from the anterior–lateral surface of the styloid process of the temporal bone, just adjacent to the stylomandibular ligament AnatomyZonewww.elsevier.com.
-
-
Insertion
-
Fibers descend anteroinferiorly, dividing into longitudinal and oblique components:
-
Longitudinal fibers blend with the inferior longitudinal intrinsic muscle of the tongue.
-
Oblique fibers interweave with hyoglossus fibers on the lateral tongue surface Radiopaediawww.elsevier.com.
-
-
-
Blood Supply
-
Primarily from the sublingual branch of the lingual artery (a branch of the external carotid).
-
Additional supply from ascending pharyngeal, ascending palatine, and tonsillar arteries NCBIRadiopaedia.
-
-
Nerve Supply
-
Innervated by the hypoglossal nerve (cranial nerve XII), which controls all intrinsic and most extrinsic tongue muscles Wikipedia.
-
-
Functions
-
Elevation of the tongue body for speech shaping.
-
Retraction of the tongue, pulling it posteriorly.
-
Formation of a trough by drawing up the sides, aiding swallowing.
-
Assistance in mastication by repositioning food.
-
Articulation support for sounds that require tongue retraction.
-
Facilitation of deglutition, guiding the food bolus into the oropharynx TeachMeAnatomy.
-
Types of Styloglossus Muscle Cancer
Styloglossus muscle tumors can be classified into:
-
Rhabdomyosarcoma Subtypes
-
Secondary Invasion by Squamous Cell Carcinoma
-
Advanced tongue squamous cell carcinoma may infiltrate the styloglossus muscle.
-
-
Other Soft Tissue Sarcomas
-
Leiomyosarcoma, malignant peripheral nerve sheath tumor, and liposarcoma arising in adjacent tissues may involve the muscle.
-
Causes (Risk Factors)
While the precise triggers for rhabdomyosarcoma remain largely unknown, several risk factors and mechanisms have been identified:
-
DNA mutations in muscle progenitor cells
-
Ionizing radiation exposure
-
Inherited cancer syndromes (Li‑Fraumeni, Beckwith‑Wiedemann)
-
Neurofibromatosis type 1
-
Noonan syndrome
-
Costello syndrome
-
Chronic inflammation
-
Previous chemotherapy (alkylating agents)
-
Environmental toxins (pesticides, vinyl chloride)
-
Viral infections (e.g., EBV in nasopharyngeal contexts)
-
Receptor tyrosine kinase/RAS/PIK3CA pathway activation
-
Loss of tumor suppressor genes (p53, Rb)
-
Trisomy of chromosomes 2, 8, 13 (embryonal subtype)
-
Epigenetic dysregulation
-
Oxidative stress
-
Aging (stem cell DNA damage)
-
Immunosuppression (HIV, transplant)
-
Tobacco smoke (in secondary invasion cases)
-
Alcohol abuse (secondary invasion)
-
Betel nut chewing (secondary invasion) Mayo Clinic.
Symptoms
Cancer in the styloglossus muscle may present with:
-
Pain in the tongue base
-
Swelling or mass sensation
-
Difficulty swallowing (dysphagia)
-
Painful swallowing (odynophagia)
-
Speech changes (slurring)
-
Tongue retraction difficulty
-
Ulceration or bleeding on the tongue surface
-
Weight loss
-
Persistent sore throat
-
Ear pain (referred)
-
Numbness or tingling in the tongue
-
Drooling
-
Increased salivation
-
Halitosis (bad breath)
-
Trismus (jaw stiffness)
-
Neck lymph node enlargement
-
Taste alteration
-
Tongue deviation toward the affected side
-
Fatigue
-
Fever (rare, paraneoplastic) Mayo Clinic.
Diagnostic Tests
-
Clinical oral examination by a specialist
-
Incisional or core-needle biopsy for tissue diagnosis
-
Histopathology to identify rhabdomyoblasts
-
Immunohistochemistry (desmin, myogenin positivity)
-
FISH/RT‑PCR for PAX–FOXO1 fusions
-
Magnetic resonance imaging (MRI) for soft tissue detail
-
Contrast-enhanced computed tomography (CT) for bone invasion
-
Positron emission tomography (PET-CT) for metastasis detection
-
Ultrasound of neck for lymph node evaluation
-
Panendoscopy (direct visualization)
-
Complete blood count (CBC) for general health
-
Liver and kidney function tests (chemo planning)
-
Lactate dehydrogenase (LDH) as a tumor marker
-
Erythrocyte sedimentation rate (ESR) for inflammation
-
C‑reactive protein (CRP)
-
Tumor markers (e.g., serum myogenin)
-
Dental panoramic X‑ray to assess mandibular involvement
-
Audiometry if ear structures involved
-
Genetic testing for inherited syndromes
-
Bone scan if suspicion of osseous spread PMCRadiopaedia.
Non‑Pharmacological Treatments
-
Surgical resection (partial glossectomy) PMC
-
Wide local excision with margin assessment
-
Neck dissection for involved lymph nodes
-
Radical glossectomy (extensive cases)
-
Reconstructive flaps (radial forearm, buccinator)
-
External beam radiotherapy (EBRT) Mayo Clinic
-
Intensity‑modulated radiotherapy (IMRT)
-
Brachytherapy (localized radiation)
-
Proton beam therapy for tissue sparing
-
Hyperthermia therapy (heat to sensitize tumor)
-
Cryosurgery (tumor freezing)
-
Laser ablation of superficial lesions
-
Photodynamic therapy
-
Focused ultrasound therapy
-
Speech therapy for articulation retraining
-
Swallowing therapy (dysphagia rehabilitation)
-
Nutrition counseling for high‑protein diet
-
Enteral feeding tube placement (PEG tube)
-
Physical therapy for neck mobility
-
Occupational therapy for daily functions
-
Psychological counseling (coping strategies)
-
Support groups (peer support)
-
Mindfulness meditation for stress relief
-
Acupuncture for pain control
-
Massage therapy (lymphatic drainage)
-
Yoga for gentle stretch and stress reduction
-
Art/music therapy for emotional support
-
Recreational therapy (engagement activities)
-
Palliative care for symptom management
-
Oral hygiene optimization to prevent infections PMCMayo Clinic.
Drugs
-
Vincristine (VCR)
-
Actinomycin D (dactinomycin)
-
Cyclophosphamide (CTX)
-
Ifosfamide (IFO)
-
Doxorubicin (Adriamycin)
-
Etoposide (VP‑16)
-
Cisplatin (CDDP)
-
Carboplatin
-
Vinblastine
-
Bleomycin
-
Methotrexate
-
Dacarbazine
-
Temozolomide
-
Pazopanib (tyrosine kinase inhibitor)
-
Trabectedin
-
Eribulin
-
Imatinib (for certain sarcomas)
-
Sorafenib
-
Sunitinib
Surgeries
-
Partial glossectomy (removal of part of the tongue)
-
Marginal glossectomy (tumor only)
-
Hemiglossectomy (half tongue removal)
-
Total glossectomy (entire tongue removal)
-
Reconstructive flap surgery (radial forearm, anterolateral thigh)
-
Microvascular free flap reconstruction
-
Selective neck dissection (levels I–III)
-
Modified radical neck dissection
-
Tracheostomy (airway support)
-
Percutaneous endoscopic gastrostomy (PEG) for feeding PMC.
Preventions
-
Avoid tobacco in any form Mayo Clinic
-
Limit alcohol consumption
-
HPV vaccination for high‑risk strains
-
Maintain excellent oral hygiene
-
Regular dental check‑ups
-
Healthy diet rich in fruits and vegetables
-
Avoid betel nut chewing
-
Use protective gear in toxin‑exposure jobs
-
Sun protection for lip and oral mucosa
-
Early treatment of oral lesions Mayo Clinic.
When to See a Doctor
-
Persistent tongue pain or lump lasting > 2 weeks
-
Difficulty swallowing or speaking that worsens
-
Unexplained bleeding from tongue or throat
-
Ear pain without ear pathology
-
Weight loss or fatigue accompanying oral symptoms
-
Numbness or altered taste in the tongue
Early evaluation by an ENT specialist or head and neck oncologist is essential for prompt diagnosis and better outcomes Mayo Clinic.
FAQs
-
What is styloglossus muscle cancer?
A rare malignant tumor of the tongue’s extrinsic muscle, often a rhabdomyosarcoma. -
Can it spread to other organs?
Yes; common metastases include lungs, lymph nodes, and bones. -
What causes it?
Exact cause unknown; linked to DNA changes, radiation, and genetic syndromes. -
How is it diagnosed?
By biopsy, imaging (MRI/CT/PET), and molecular tests. -
Is it curable?
Early-stage tumors have better prognosis; multimodal therapy (surgery + chemo + radiation) can be curative. -
What is the role of surgery?
Mainstay for local control, often followed by reconstruction. -
Are there non‑drug treatments?
Yes—radiation, hyperthermia, laser, and supportive therapies like speech therapy. -
What side effects to expect?
Mucositis, speech/swallowing difficulties, dry mouth, and fatigue. -
How long is treatment?
Varies by stage; typically 6–12 months of combined therapy. -
Can children get this cancer?
Yes, embryonal subtype is most common in children. -
Is genetic testing recommended?
For those with family cancer syndromes, yes. -
What follow‑up is needed?
Regular imaging and clinical exams for at least 5 years. -
Can it recur?
There is a risk; recurrence rates depend on subtype and margins. -
What support resources exist?
Sarcoma support groups, speech/swallow clinics, nutritionists, and psychological counseling. -
How to reduce risk?
Maintain oral health, avoid tobacco/alcohol, get HPV vaccine, and seek early care for oral lesions.
Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.
The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members
Last Updated: April 18, 2025.