Tongue Inferior Longitudinal Muscle Tumors

Tumors of the inferior longitudinal muscle of the tongue are abnormal growths—benign or malignant—that arise within the intrinsic muscle fibers located on the underside of the tongue. They can distort tongue shape and movement, causing symptoms like lumps, pain, or difficulty speaking and swallowing.

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Anatomy of the Inferior Longitudinal Muscle

A precise grasp of anatomy is vital to understanding how tumors affect tongue function.

Structure & Location

• Intrinsic muscle lying entirely within the tongue’s substance

• Positioned on the ventral (under) surface, between the genioglossus and hyoglossus muscles

Origin

• Arises from the root (base) of the tongue

Insertion

• Inserts at the apex (tip) of the tongue

Blood Supply

• Supplied by branches of the lingual artery, especially the deep lingual artery, with contributions from dorsal lingual branches kenhub.com

Nerve Supply

• Motor innervation via the hypoglossal nerve (cranial nerve XII)

Key Functions

1. Shortening the tongue, broadening its body

2. Thickening the tongue by increasing its vertical dimension

3. Retracting the tongue backward into the mouth

4. Depressing (lowering) the tongue tip—ventroflexion

5. Curling the sides of the tongue downward to shape food bolus

6. Assisting speech and swallowing by fine-tuning tongue posture

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Types of Tumors

Tumors are classified by tissue of origin:

1. Epithelial (Salivary/Surface) Tumors

   • Squamous cell carcinoma

   • Adenoid cystic carcinoma

   • Mucoepidermoid carcinoma

2. Benign Mesenchymal Tumors

   • Granular cell tumor

   • Leiomyoma

   • Hemangioma & lymphangioma

   • Schwannoma & neurofibroma

   • Fibroma & lipoma

3. Malignant Mesenchymal Tumors

   • Rhabdomyosarcoma

   • Leiomyosarcoma

   • Fibrosarcoma

   • Angiosarcoma

4. Neural Tumors

   • Schwannoma

   • Neurofibroma

5. Lymphoid & Hematologic Tumors

   • Lymphoma

6. Metastatic Lesions

   • Melanoma

   • Carcinomas from distant sites

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Causes

(Often called risk factors rather than direct causes.)

1. Tobacco smoking

2. Chewing tobacco (snuff)

3. Heavy alcohol consumption

4. Combined tobacco–alcohol use

5. Human papillomavirus (HPV) infection

6. Chronic mechanical irritation (sharp teeth, dentures)

7. Poor oral hygiene

8. Betel quid (areca nut) chewing

9. Oral submucous fibrosis

10. Genetic mutations (e.g., p53)

11. Immunosuppression (HIV/AIDS)

12. Epstein–Barr virus (lymphoma risk)

13. Syphilitic lesions

14. Chronic candidiasis

15. Oral lichen planus

16. Nutritional deficiencies (vitamins A, C, E)

17. Previous radiation to head/neck

18. Occupational carcinogens (wood dust, nickel)

19. Dietary nitrosamines

20. Age over 50 years

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Symptoms

1. Lump or mass under the tongue

2. Persistent tongue ulcer

3. Pain or tenderness in the tongue

4. Bleeding from the tongue

5. Difficulty swallowing (dysphagia)

6. Painful swallowing (odynophagia)

7. Slurred speech (dysarthria)

8. Change in taste

9. Numbness of tongue or mouth

10. Ear pain (referred)

11. Swelling under the jaw

12. Halitosis (bad breath)

13. Weight loss

14. Excess saliva or drooling

15. Tongue stiffness or reduced mobility

16. Difficulty chewing

17. White or red patches (leukoplakia/erythroplakia)

18. Neck lymph node enlargement

19. Sore throat not improving

20. Foul mouth odor

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Diagnostic Tests

1. Clinical oral examination

2. Palpation of tongue and floor of mouth

3. Toluidine blue rinse (lesion highlighting)

4. Indirect or direct laryngoscopy

5. Incisional biopsy (sample removal)

6. Excisional biopsy (entire lesion)

7. Fine-needle aspiration cytology (FNAC)

8. Histopathology & immunohistochemistry

9. HPV-16/18 PCR testing

10. Contrast-enhanced CT scan of head/neck

11. MRI for soft-tissue detail

12. Ultrasound of tongue & neck

13. PET-CT for metastasis

14. Chest X-ray (lung metastases)

15. Complete blood count (CBC)

16. Liver & kidney function tests

17. Panendoscopy (esophago-bronchoscopy)

18. Dental panoramic X-ray

19. Sentinel lymph node biopsy

20. Tumor marker studies (e.g., p16)

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Non-Pharmacological Treatments

1. Surgical excision (tumor removal)

2. Radiation therapy (external beam)

3. Brachytherapy (internal radiation)

4. Photodynamic therapy

5. Laser ablation

6. Cryotherapy

7. Hyperbaric oxygen therapy

8. Speech therapy

9. Swallowing (dysphagia) therapy

10. Oral motor exercises

11. Physical therapy (neck/jaw ROM)

12. Occupational therapy

13. Nutritional counseling

14. Feeding tube placement (PEG)

15. Prosthetic rehabilitation (palatal ramp)

16. Dental hygiene optimization

17. Denture adjustment or new prosthesis

18. Myofunctional therapy

19. Low-level laser therapy for pain

20. Acupuncture for pain & nausea

21. Massage therapy (neck/shoulder)

22. Mindfulness & relaxation techniques

23. Yoga & gentle stretching

24. Psychological counseling

25. Support groups & peer support

26. Smoking cessation programs

27. Alcohol reduction counseling

28. Oral hygiene routines (chlorhexidine rinses)

29. Antioxidant-rich diet coaching

30. Regular dental & ENT follow-up

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Drugs

(Primarily for malignant tumors.)

1. Cisplatin

2. Carboplatin

3. 5-Fluorouracil (5-FU)

4. Methotrexate

5. Bleomycin

6. Paclitaxel

7. Docetaxel

8. Cyclophosphamide

9. Doxorubicin

10. Vincristine

11. Ifosfamide

12. Topotecan

13. Cetuximab (anti-EGFR)

14. Erlotinib (EGFR TKI)

15. Gefitinib (EGFR TKI)

16. Pembrolizumab (anti-PD-1)

17. Nivolumab (anti-PD-1)

18. Durvalumab (anti-PD-L1)

19. Combination TPF (Taxane + Platinum + 5-FU)

20. Cetuximab + Cisplatin

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Surgical Procedures

1. Incisional biopsy

2. Excisional biopsy

3. Partial glossectomy (wedge resection)

4. Hemiglossectomy

5. Total glossectomy

6. Transoral laser microsurgery

7. Selective neck dissection

8. Modified radical neck dissection

9. Microvascular free-flap reconstruction

10. Pedicled flap reconstruction

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Prevention Strategies

1. Avoid all tobacco products

2. Limit or eliminate alcohol

3. Get HPV vaccination

4. Maintain excellent oral hygiene

5. Visit dentist regularly

6. Avoid betel quid/areca nut

7. Eat a balanced diet rich in fruits & vegetables

8. Fix sharp teeth or ill-fitting dentures

9. Use lip balm with SPF for sun protection

10. Monitor and treat pre-cancerous oral lesions early

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When to See a Doctor

Seek medical attention if you have any of these that persist for >2 weeks:

• A lump or ulcer on the tongue or floor of mouth

• Unexplained pain or bleeding in the mouth

• Difficulty or pain when swallowing or speaking

• Numbness, earache, or swelling in the neck

• Weight loss or loss of appetite

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Frequently Asked Questions

1. What is the inferior longitudinal muscle?
   A thin intrinsic muscle under the tongue that shapes and moves its tip.

2. What causes tumors here?
   Mostly risk factors like tobacco, alcohol, HPV, and chronic irritation.

3. How common are these tumors?
   Rare compared with other tongue cancers, but still important to check.

4. What are early warning signs?
   Lumps, ulcers, pain, bleeding, or persistent changes in tongue appearance.

5. How are they diagnosed?
   Through clinical exam, imaging (MRI/CT), and biopsy with lab tests.

6. Is biopsy painful?
   Local anesthesia is used; you may feel pressure but minimal pain.

7. What treatment options exist?
   Surgery, radiation, chemotherapy, plus supportive therapies.

8. Can speech return to normal?
   Often yes, with speech therapy and appropriate reconstruction.

9. Are non-drug therapies effective?
   Yes—radiation, laser, photodynamic therapy, plus rehab support.

10. What are common chemotherapy drugs?
    Cisplatin, 5-FU, taxanes, and newer immunotherapies (e.g., pembrolizumab).

11. What surgical choices are there?
    From small wedge resections to partial or total glossectomy with reconstruction.

12. Can I prevent these tumors?
    Yes—by avoiding tobacco/alcohol, maintaining oral health, and getting HPV vaccine.

13. How is prognosis?
    Varies by tumor type and stage; early detection offers best outcomes.

14. Do these tumors spread?
    Malignant types can spread locally or to lymph nodes and distant sites.

15. When is follow-up needed?
    Regular check-ups every 3–6 months for 2 years, then annually.

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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