Malignant Tumors of the Base of Tongue Clinical Presentation

Updated: Apr 05, 2021
  • Author: Rishi Sethia, MD; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Presentation

History

As in all head and neck cancers, it is essential to gather a thorough history, with an emphasis on common risk factors such as tobacco and alcohol use. Patients with base of tongue tumors may present with dysphagia, odynophagia, foreign body sensation, referred otalgia, oral bleeding, or a neck mass. In advanced disease, patients can present with obstructive symptoms such as dyspnea and inability to tolerate secretions. General health status, including cardiac and pulmonary history, previous surgery or radiation treatment, and use of anticoagulation therapy, are also important to evaluate given the potential implications on treatment and outcomes.

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Physical Examination

A comprehensive head and neck examination is recommended for all patients, including detailed cranial nerve examination and palpation of the neck to assess for regional metastatic lymphadenopathy. Inspection and palpation of the tongue base may be limited by inadequate access to equipment, poor patient compliance, or submucosal extent of disease. Office indirect or flexible fiberoptic laryngoscopy is a useful adjunct to the physical examination.

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