Tongue Superior Longitudinal Muscle Tumor s

A tongue superior longitudinal muscle tumor refers to any abnormal growth arising in or infiltrating the superior longitudinal muscle, one of the four intrinsic muscles that shape the tongue. These tumors may be benign (non‑cancerous) or malignant (cancerous) and can interfere with tongue movement, speech, and swallowing. Although primary tumors originating from skeletal muscle cells in this location are rare, the superior longitudinal muscle is often involved when cancers of the tongue—especially squamous cell carcinoma—invade deeper tissues PMCPMC.

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Anatomy of the Superior Longitudinal Muscle

1. Structure & Location

   • A thin, broad sheet of muscle fibers immediately beneath the dorsal mucosa of the tongue’s anterior two‑thirds, lying just above the transverse and vertical intrinsic muscles NCBIWikipedia.

2. Origin

   • Fibers arise from the median fibrous septum near the epiglottis and adjacent submucosal tissue Wikipedia.

3. Insertion

   • Fibers insert broadly along the lateral and apical margins of the tongue, beneath the mucous membrane Wikipedia.

4. Blood Supply

   • Primarily from branches of the lingual artery, which supplies intrinsic tongue muscles www.elsevier.com.

5. Nerve Supply

   • Motor innervation by the hypoglossal nerve (cranial nerve XII) Wikipedia.

6. Functions (six key actions)

   1. Shortens the tongue, making it thicker and wider.

   2. Elevates and curls the tip and sides (dorsiflexion).

   3. Retracts the tongue in concert with the inferior longitudinal muscle.

   4. Shapes the tongue for precise speech sounds.

   5. Assists in manipulating food during chewing.

   6. Contributes to swallowing by coordinating tongue movements NCBIRadiopaedia.

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Types of Tumors

• Benign Mesenchymal Tumors

  • Rhabdomyoma, leiomyoma, fibroma, lipoma, granular cell tumor (Schwann cell origin) PMC.

• Malignant Soft Tissue Sarcomas

  • Rhabdomyosarcoma (embryonal, alveolar, pleomorphic subtypes), leiomyosarcoma, fibrosarcoma, undifferentiated pleomorphic sarcoma .

• Invasive Squamous Cell Carcinoma (SCC)

  • The most common oral cancer, arising in the mucosa and invading intrinsic muscles, including the superior longitudinal muscle PMCPMC.

• Other Malignancies

  • Malignant peripheral nerve sheath tumor, alveolar soft part sarcoma, angiosarcoma, and synovial sarcoma (rare in tongue) PMC.

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Causes (Risk Factors)

1. Tobacco smoking (cigarettes, cigars, pipes) Cancer Info and Resources

2. Chewing tobacco and snuff Cancer Info and Resources

3. Heavy alcohol consumption Cancer Info and Resources

4. Betel quid and areca nut chewing (common in South Asia) Canadian Cancer Society

5. Human papillomavirus (HPV) infection, especially types 16/18 Cancer Info and Resources

6. Age over 50 years Cancer Info and Resources

7. Male sex (twice the risk of females) Cancer Info and Resources

8. Excess body weight and obesity Cancer Info and Resources

9. Poor nutrition (low fruits/vegetables) Cancer Info and Resources

10. Family history of head and neck cancers Canadian Cancer Society

11. Prior head and neck radiation exposure Wikipedia, l’enciclopedia libera

12. Genetic syndromes (e.g., Li‑Fraumeni, Fanconi anemia)

13. Immunosuppression (HIV, transplant patients) Wikipedia, l’enciclopedia libera

14. Chronic oral irritation (sharp teeth, dental appliances) Wikipedia, l’enciclopedia libera

15. Betel leaf additives (lime, spices) Wikipedia, l’enciclopedia libera

16. Alcohol‑containing mouthwash (controversial) Wikipedia, l’enciclopedia libera

17. Poor oral hygiene Canadian Cancer Society

18. Occupational exposure to wood dust, formaldehyde Wikipedia, l’enciclopedia libera

19. UV light (lip cancers) Cancer Info and Resources

20. Chronic candidiasis and HPV synergy Wikipedia, l’enciclopedia libera.

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Symptoms

Patients with tumors in the superior longitudinal muscle often report:

1. A lump or thickening on the tongue Wikipedia

2. Persistent tongue pain or tenderness Wikipedia

3. Ulcer or sore on tongue not healing in >2 weeks Wikipedia

4. Difficulty swallowing (dysphagia) Wikipedia

5. Changes in speech or slurred speech Wikipedia

6. Bleeding from the tongue Wikipedia

7. Numbness or loss of sensation in tongue Wikipedia

8. Ear pain on the same side (referred otalgia) Wikipedia

9. Stiffness or limited tongue mobility Wikipedia

10. Weight loss due to eating difficulties Wikipedia

11. Bad breath (halitosis) Wikipedia

12. White or red patches on tongue (leukoplakia/erythroplakia) Wikipedia

13. Sore throat Wikipedia

14. Lump in neck (lymph node enlargement) Wikipedia

15. Unexplained facial swelling Wikipedia

16. Difficulty opening mouth (trismus) Wikipedia

17. Drooling due to impaired swallowing Wikipedia

18. Pain when chewing Wikipedia

19. Taste changes or loss of taste Wikipedia

20. General fatigue and malaise Wikipedia.

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Diagnostic Tests

1. Physical exam of tongue and oral cavity Radiologyinfo.org

2. Biopsy (incisional/excisional) for histology American Oncology Institute

3. Fine needle aspiration of neck nodes American Oncology Institute

4. Brush cytology (exfoliative) Virginia Cancer Specialists

5. Toluidine blue staining to highlight abnormal mucosa City of Hope Cancer Treatment Centers

6. Magnetic Resonance Imaging (MRI) for soft‑tissue detail Cancer Info and Resources

7. Computed Tomography (CT) scan for bone invasion and staging Cancer Research UK

8. Positron Emission Tomography (PET/CT) for metastatic workup Cancer Info and Resources

9. Ultrasound of the neck Cancer Research UK

10. Orthopantomogram (OPG) dental X‑ray Cancer Research UK

11. Chest X‑ray/CT for lung metastases Radiologyinfo.org

12. Endoscopy (flexible nasoendoscope) Virginia Cancer Specialists

13. Panendoscopy under anesthesia for synchronous lesions Mayo Clinic

14. Sentinel lymph node biopsy Radiologyinfo.org

15. Barium swallow for swallowing assessment Cancer Research UK

16. Blood tests (CBC, LFTs, renal function) Mayo Clinic

17. Genetic/molecular testing (e.g., PAX‑FOXO1 in rhabdomyosarcoma) ASHA Publications

18. Ultrasound‑guided core biopsy Virginia Cancer Specialists

19. Fluorescence imaging (autofluorescence) City of Hope Cancer Treatment Centers

20. Speech and swallow evaluation (by therapist) Mayo Clinic.

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Non‑Pharmacological Treatments

1. Surgical resection (glossectomy) Wikipedia

2. Radiation therapy (external beam) Mayo Clinic

3. Brachytherapy (interstitial) Mayo Clinic

4. Photodynamic therapy City of Hope Cancer Treatment Centers

5. Laser ablation (CO₂ laser) E-ACFS

6. Cryotherapy City of Hope Cancer Treatment Centers

7. Hyperbaric oxygen therapy Mayo Clinic

8. Speech therapy Cleveland Clinic

9. Swallowing (dysphagia) therapy Cleveland Clinic

10. Nutritional support (dietitian) Cleveland Clinic

11. Physical therapy (neck/shoulder) JournalAgent

12. Occupational therapy (activities of daily living) JournalAgent

13. Psychosocial counseling JournalAgent

14. Support groups JournalAgent

15. Acupuncture (pain, xerostomia) Medical News Today

16. Yoga and meditation (stress reduction) Medical News Today

17. Massage therapy (lymphatic drainage) Medical News Today

18. Oral hygiene protocols (chlorhexidine rinse) Advanced Dentistry

19. Mouthguard for radiation protection Cleveland Clinic

20. Laser photobiomodulation (mucositis prevention) Mayo Clinic

21. Saline or baking soda mouth rinses Medical News Today

22. Ice chips for mucositis relief Medical News Today

23. Probiotics for oral microbiome balance Medical News Today

24. Dietary modifications (soft diet, high protein) Cleveland Clinic

25. Smoking cessation programs Cancer Info and Resources

26. Alcohol cessation support Brigham and Women’s Hospital

27. Biofeedback for swallowing JournalAgent

28. Speech‑swallow biofeedback with instrumental imaging JournalAgent

29. Electrostimulation therapy for swallowing muscles JournalAgent

30. Psychological mindfulness training Medical News Today.

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Drugs

Anticancer Agents

1. Cisplatin PMCLippincott Journals

2. Carboplatin Lippincott Journals

3. 5‑Fluorouracil (5‑FU) PMCLippincott Journals

4. Docetaxel PMC

5. Paclitaxel PMC

6. Methotrexate Lippincott Journals

7. Capecitabine Lippincott Journals

8. Gemcitabine Lippincott Journals

9. Cetuximab (EGFR‑mAb) PMC

10. Panitumumab PMC

11. Zalutumumab PMC

12. Nimotuzumab PMC

13. Pembrolizumab (anti‑PD‑1) PMC

14. Nivolumab (anti‑PD‑1) PMC

15. Erlotinib (EGFR‑TKI) PMC
    Supportive Medications

16. Ondansetron (antiemetic) Mayo Clinic

17. Dexamethasone (antiemetic adjunct) Mayo Clinic

18. Morphine (pain) Mayo Clinic

19. Fentanyl patch (pain) Mayo Clinic

20. Gabapentin (neuropathic pain) Mayo Clinic.

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Surgeries

1. Partial glossectomy (removal of part of the tongue) Wikipedia

2. Hemiglossectomy (half the tongue) Wikipedia

3. Total glossectomy (entire tongue) Wikipedia

4. Radical neck dissection (removal of lymph nodes and surrounding tissue) Wikipedia

5. Modified radical neck dissection (preserving some structures) Wikipedia

6. Sentinel lymph node biopsy Radiologyinfo.org

7. Free flap reconstruction (radial forearm, anterolateral thigh) JournalAgent

8. Local flap reconstruction (tongue tissue rearrangement) JournalAgent

9. Tracheostomy (breathing support) Cleveland Clinic

10. Percutaneous endoscopic gastrostomy (PEG) tube placement Cleveland Clinic.

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Prevention Strategies

1. Avoid tobacco in all forms (smoking & chewing) Cancer Info and ResourcesCanadian Cancer Society

2. Limit alcohol consumption Cancer Info and ResourcesBrigham and Women’s Hospital

3. HPV vaccination (Gardasil 9) Canadian Cancer Society

4. Regular dental checkups for early lesion detection Healthline

5. Avoid betel quid & areca nut Canadian Cancer Society

6. Protect lips from sun with SPF & hats Smiles for Centreville

7. Maintain oral hygiene (daily brushing/flossing) Advanced Dentistry

8. Healthy diet rich in fruits & vegetables Healthline

9. Avoid alcohol‑based mouthwashes Medical News Today

10. Quit smoking via cessation programs Cancer Info and Resources.

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When to See a Doctor

• A tongue sore, lump, or ulcer that does not heal within 2 weeks Wikipedia

• Persistent pain or numbness in the tongue Wikipedia

• Difficulty swallowing or speaking Wikipedia

• Unexplained weight loss or fatigue Wikipedia

• New onset ear pain (referred) Wikipedia.

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Frequently Asked Questions

1. What is a superior longitudinal muscle tumor?
   It’s an abnormal growth in the intrinsic tongue muscle that can be benign (e.g., rhabdomyoma) or malignant (e.g., rhabdomyosarcoma or invasive squamous cell carcinoma) PMC.

2. How common are these tumors?
   Primary muscle tumors in the tongue are very rare; most tongue cancers are squamous cell carcinomas invading muscle fibers PMC.

3. Can these tumors be painless?
   Yes. Early-stage squamous cell carcinomas often start as painless patches, only causing pain once they invade deeper tissues Wikipedia.

4. How are they diagnosed?
   Diagnosis requires a biopsy with histopathology and imaging (MRI/CT) to assess extent Cancer Info and Resources.

5. Are these tumors cancerous?
   They may be benign or malignant; only biopsy and pathology can confirm cancer American Oncology Institute.

6. What is the prognosis?
   Depends on type, stage, and depth of invasion; early detection of squamous cell carcinoma has a 5‑year survival of around 65% Wikipedia.

7. Can these tumors spread?
   Malignant tumors can metastasize to lymph nodes and distant organs PMC.

8. What treatments are available?
   Surgery, radiation therapy, chemotherapy, targeted therapy, and supportive care Mayo Clinic.

9. Will I lose tongue function?
   Partial resections can preserve many functions; reconstruction and therapy aim to restore speech and swallowing Cleveland Clinic.

10. What are common side effects of treatment?
    Mucositis, dry mouth, taste changes, swallowing difficulty, and nerve damage Mayo Clinic.

11. How can I prevent recurrence?
    Avoid risk factors, complete recommended therapy, and attend regular follow‑up exams Cancer Info and Resources.

12. What nutritional support do I need?
    A high‑protein, soft diet with supplements may be required during recovery Cleveland Clinic.

13. Can I speak normally after treatment?
    With rehabilitation, many patients regain understandable speech, though some changes may persist Cleveland Clinic.

14. Is HPV vaccination helpful?
    Yes. Vaccination reduces the risk of HPV‑driven oropharyngeal cancers that may invade tongue muscles Canadian Cancer Society.

15. How often should I have check‑ups?
    Every 1–3 months in the first year, then spacing out over time, based on your specialist’s advice Radiologyinfo.org.

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The article is written by Team Rxharun and reviewed by the Rx Editorial Board Members

Last Updated: April 22, 2025.

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