Tongue Inferior Longitudinal Muscle Cancer

Tongue inferior longitudinal muscle cancer is a type of oral cancer that arises when abnormal cells in the inferior longitudinal intrinsic muscle of the tongue begin to grow uncontrollably, forming a malignant tumor. This cancer most often takes the form of squamous cell carcinoma, which originates in the flat, thin cells lining the tongue’s surface. As the tumor enlarges, it invades the muscle fibers of the inferior longitudinal muscle, impairing tongue movement, speech, and swallowing. Early detection is critical, because when identified promptly, treatment can often remove or destroy the tumor and preserve function. Cleveland ClinicMayo Clinic

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Anatomy of the Tongue Inferior Longitudinal Muscle

The inferior longitudinal muscle is one of four intrinsic muscles that lie entirely within the tongue. Understanding its anatomy is key to appreciating how cancer in this muscle affects tongue function.

Structure & Location

• Shape & Size: A thin, flat, narrow band situated immediately beneath the ventral (under) surface of the tongue.

• Position: It lies deep to the mucosal layer, between the genioglossus (medial and lateral) and hyoglossus muscles.

Origin

• Arises from the root of the tongue, blending posteriorly with fibers attached to the hyoid bone.

Insertion

• Inserts into the apex (tip) of the tongue, where its fibers blend anteriorly with those of the styloglossus, hyoglossus, and genioglossus muscles.

Blood Supply

• Receives arterial blood mainly from the deep lingual artery, a branch of the lingual artery, with additional contributions from submental branches of the facial artery.

Nerve Supply

• Motor innervation by the hypoglossal nerve (cranial nerve XII), which carries impulses necessary for muscle contraction.

Functions

1. Shortening the tongue length when contracted, aiding in retraction.

2. Thickening the tongue by broadening its body.

3. Curling the apex downward (ventroflexion), shaping the tip.

4. Assisting retraction in concert with the superior longitudinal muscle when pulling the tongue back into the mouth.

5. Facilitating precise articulation in speech by altering tongue shape.

6. Supporting efficient swallowing by helping form a seal against the palate and directing food toward the throat.

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Types of Tongue Inferior Longitudinal Muscle Cancer

Although any malignant tumor in the tongue muscle is rare, several histological types can affect the inferior longitudinal muscle:

1. Squamous Cell Carcinoma (SCC) – Accounts for over 90% of tongue cancers; arises from the squamous epithelial cells lining the tongue surface. moffitt.orgCleveland Clinic

2. Verrucous Carcinoma – A low-grade variant of SCC with slow growth but deep local invasion. Cancer Research UK

3. Adenoid Cystic Carcinoma – Originates in minor salivary gland tissue within the tongue; known for perineural invasion. Cancer Research UK

4. Mucoepidermoid Carcinoma – Another salivary gland–derived malignancy, mixing mucus-secreting and squamous cells. Cancer Research UK

5. Lymphoma – Cancer of lymphoid tissue that can involve the tongue, often non–Hodgkin type. Cancer Research UK

6. Melanoma – Rare malignant tumor of melanocytes on the tongue’s surface. Cancer Research UK

7. Sarcoma – Originates in connective tissue; extremely rare in the tongue. Cancer Research UK

8. Metastatic Tumors – Secondary spread from cancers elsewhere (e.g., lung, breast). Mayo Clinic

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Causes (Risk Factors)

Multiple factors can increase the risk of developing tongue inferior longitudinal muscle cancer:

1. Tobacco use (cigarettes, cigars, smokeless tobacco)

2. Heavy alcohol consumption

3. Human papillomavirus (HPV) infection, especially HPV-16

4. Poor oral hygiene and chronic periodontal disease

5. Chronic irritation (e.g., sharp tooth edges, ill-fitting dentures)

6. Betel nut chewing

7. Radiation exposure to head and neck region

8. High–salt diet and deficiencies of fruits/vegetables

9. Age over 40

10. Male gender (twice as common as females)

11. Family history of head and neck cancers

12. Immunosuppression (e.g., HIV, transplant patients)

13. Occupational exposure to wood dust, formaldehyde

14. Gastroesophageal reflux disease (GERD) causing chronic irritation

15. Prior oral cancer increases risk of second primary

16. Genetic syndromes (e.g., Fanconi anemia)

17. Poor nutritional status

18. Chronic candidiasis (fungal infections)

19. Heavy metal exposure (e.g., nickel, chromium)

20. Sun exposure (for lip involvement) Mayo ClinicCity of Hope Cancer Treatment Centers

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Symptoms

Early signs of inferior longitudinal muscle involvement may be subtle. Common symptoms include:

1. Persistent sore or ulcer on the under surface of the tongue that doesn’t heal

2. Lump or thickening in the tongue

3. Pain or tenderness in the tongue or mouth

4. Bleeding from the tongue without injury

5. Difficulty moving the tongue (reduced mobility)

6. Changes in speech (slurred or unclear)

7. Difficulty swallowing (dysphagia)

8. Pain on swallowing (odynophagia)

9. Altered taste sensation (dysgeusia)

10. Numbness or tingling of the tongue

11. Ear pain (referred otalgia)

12. Weight loss or poor appetite

13. Neck swelling (enlarged lymph nodes)

14. Halitosis (bad breath)

15. Salivation changes (excessive drooling)

16. Jaw stiffness or locked jaw

17. Ulcer with raised edges

18. Trismus (difficulty opening the mouth)

19. Loose teeth if the tumor invades bone

20. Difficulty clearing food particles from tongue surface Mayo ClinicVerywell Health

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Diagnostic Tests

Accurate diagnosis combines clinical examination with laboratory and imaging studies:

1. Complete oral examination by a specialist

2. Incisional biopsy of the lesion with histopathology

3. Excisional biopsy (small lesions)

4. Brush biopsy (adjunctive screening)

5. Toluidine blue staining to highlight abnormal cells

6. Direct laryngoscopy and oral endoscopy

7. Magnetic Resonance Imaging (MRI) of the tongue and neck Memorial Sloan Kettering Cancer Center

8. Computed Tomography (CT) scan for bone invasion and lymph nodes Memorial Sloan Kettering Cancer Center

9. Positron Emission Tomography (PET-CT) for distant metastases Memorial Sloan Kettering Cancer Center

10. Ultrasound of neck lymph nodes with fine-needle aspiration cytology

11. Panoramic radiograph (orthopantomogram)

12. Chest X-ray for lung metastasis screening

13. Blood tests (CBC, liver/kidney function)

14. Human papillomavirus (HPV) testing (p16 immunohistochemistry)

15. Immunohistochemistry for tumor markers

16. Genomic profiling for targeted therapy suitability

17. Sentinel lymph node biopsy

18. Dental evaluation for prosthetic planning

19. Swallow study (videofluoroscopy) for functional assessment

20. Nutritional assessment for therapy planning

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Non-Pharmacological Treatments

Supportive and local therapies can complement medical and surgical care:

1. Surgical excision of the tumor with clear margins

2. Partial glossectomy (removal of part of tongue)

3. Hemiglossectomy (one-sided removal)

4. Total glossectomy (complete removal)

5. Neck dissection (lymph node removal)

6. Flap reconstruction (e.g., radial forearm free flap)

7. Microvascular free tissue transfer for tongue reconstruction

8. Laser ablation therapy for superficial lesions

9. Photodynamic therapy to destroy cancer cells using light-activated drugs

10. Cryotherapy (freezing tumor tissue)

11. High-dose-rate brachytherapy implant

12. External beam radiation therapy

13. Intensity-modulated radiation therapy (IMRT)

14. Proton beam therapy to spare surrounding tissues

15. Hyperbaric oxygen therapy to promote healing post-radiation

16. Speech therapy to restore articulation and swallowing People.com

17. Physical therapy for neck and jaw mobility

18. Occupational therapy for daily living adaptations

19. Nutritional counseling to maintain weight and healing

20. Oral hygiene protocols to prevent infection

21. Mindfulness and relaxation techniques for pain management

22. Acupuncture for symptom relief

23. Lymphatic drainage massage to reduce swelling

24. Prosthetic tongue appliances for speech improvement

25. Voice therapy to optimize residual tongue function

26. Art and music therapy for emotional support

27. Cognitive-behavioral therapy for coping strategies

28. Patient support groups for shared experiences

29. Tobacco cessation programs

30. Alcohol counseling services People.com

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Drug Treatments

Systemic therapies play a key role, especially in advanced disease or when surgery/radiation alone is insufficient:

1. Cisplatin (platinum-based chemotherapy)

2. Carboplatin (alternative platinum agent)

3. 5-Fluorouracil (5-FU)

4. Paclitaxel

5. Docetaxel

6. Methotrexate

7. Capecitabine (oral 5-FU prodrug)

8. Bleomycin

9. Doxorubicin (adriamycin)

10. Cetuximab (EGFR inhibitor)

11. Panitumumab (EGFR monoclonal antibody)

12. Nivolumab (PD-1 immune checkpoint inhibitor)

13. Pembrolizumab (PD-1 inhibitor)

14. Durvalumab (PD-L1 inhibitor)

15. Ipilimumab (CTLA-4 inhibitor)

16. Erlotinib (EGFR tyrosine kinase inhibitor)

17. Gefitinib (EGFR TKI)

18. Temozolomide (alkylating agent)

19. Vinorelbine

20. Induction (neoadjuvant) chemotherapy combinations (e.g., TPF: docetaxel, cisplatin, 5-FU) NCBI

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Surgical Options

When feasible, surgery offers the best chance for cure:

1. Wide local excision of tumor with negative margins

2. Partial glossectomy (up to one-third of tongue)

3. Hemiglossectomy (half of tongue removed)

4. Total glossectomy (complete tongue removal)

5. Modified radical neck dissection (levels I–III lymph nodes)

6. Radical neck dissection (levels I–V)

7. Sentinel lymph node biopsy for staging

8. Free flap reconstruction (radial forearm, anterolateral thigh)

9. Pedicled flap reconstruction (pectoralis major myocutaneous)

10. Immediate dental implant placement during reconstruction

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Prevention Strategies

While not all cancers are preventable, risk reduction can lower incidence:

1. Avoid all forms of tobacco (smoking, chewing)

2. Limit alcohol intake or abstain

3. HPV vaccination (prevents HPV-related cancers) Wikipedia

4. Maintain excellent oral hygiene

5. Regular dental checkups for early lesion detection

6. Avoid betel nut chewing

7. Balanced diet rich in fruits, vegetables, antioxidants

8. Protect lips from sun with SPF lip balm

9. Manage GERD and reflux to reduce chronic irritation

10. Occupational protections against chemical exposures

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When to See a Doctor

Seek prompt medical evaluation if you notice any of the following lasting more than two weeks:

• A persistent tongue sore or ulcer that does not heal

• A firm lump or thickening on the tongue or under the tongue

• Unexplained bleeding from the tongue

• Ongoing pain in the tongue, mouth, or ear

• Difficulty speaking, chewing, or swallowing Verywell Health

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Frequently Asked Questions (FAQs)

1. What causes tongue inferior longitudinal muscle cancer?
   Most cases arise from squamous cell carcinoma triggered by tobacco, alcohol, or HPV infection. Chronic irritation and poor oral hygiene also contribute. Mayo Clinic

2. Is tongue cancer curable?
   Yes—if caught early (stage I–II), five-year survival can exceed 80%. Late-stage disease has a lower cure rate. Verywell Health

3. How is it diagnosed?
   Through clinical exam, biopsy, imaging (MRI/CT/PET), and lab tests including HPV status. Memorial Sloan Kettering Cancer Center

4. What treatments are available?
   Surgical removal, radiation therapy, chemotherapy, targeted therapy, immunotherapy, or combinations tailored to stage and patient health. Memorial Sloan Kettering Cancer Center

5. Can it recur after treatment?
   Yes—regular follow-up exams are crucial, especially within the first two years post-treatment when recurrence risk is highest. Health

6. What side effects might I experience?
   Side effects include pain, dry mouth, changes in taste, difficulty swallowing, speech changes, and potential nutritional issues. Health

7. How can I maintain nutrition?
   Work with a dietitian for calorie-dense, soft or pureed diets; consider feeding tube support if swallowing is severely impaired. People.com

8. Does HPV-positive cancer have a better prognosis?
   Yes—HPV-positive tongue cancers often respond better to treatment and have higher survival rates. Verywell Health

9. How often should I have follow-up exams?
   Typically every 1–3 months in the first year, gradually spacing to every 6–12 months after two years without recurrence. Health

10. Is radiation therapy painful?
    The procedure itself is painless, but side effects like mucositis (mouth sores) and skin irritation can cause discomfort. Memorial Sloan Kettering Cancer Center

11. Can I still speak normally after surgery?
    Depending on the extent of surgery, speech therapy and rehabilitation can often restore intelligible speech. People.com

12. Are there support resources available?
    Yes—cancer support groups, speech and swallowing therapists, dietitians, and mental health counselors. People.com

13. How do I prevent recurrence?
    Avoid tobacco and alcohol, maintain oral hygiene, attend all follow-up visits, and report any new symptoms immediately. Health

14. Does cigarette smoking after treatment affect prognosis?
    Continued smoking increases risk of recurrence and second primary cancers; cessation is strongly advised. City of Hope Cancer Treatment Centers

15. Can alternative therapies help?
    Some supportive therapies (acupuncture, mindfulness) can aid symptom management, but they should complement—and not replace—standard cancer treatments. People.com

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 23, 2025.

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