Prolonged unhealed ulcers on the tongue

If the same oral ulcer does not improve for more than three weeks, it should be noted that such hard-to-heal ulcers or prominent ulcer wounds are likely to be an early signal of oral cancer. Tongue cancer is the most common oral cancer, with more men than women. Most tongue cancers are squamous cell carcinomas. Especially in the front 2/3 of the tongue, adenocarcinomas are rare and mostly located at the root of the tongue. Sometimes, lymph epithelial cancer and undifferentiated cancer may occur at the root of the tongue. Tongue cancer mostly occurs at the edge of the tongue, followed by the tip of the tongue, the back of the tongue, and the root of the tongue. It is often ulcerous or invasive. Generally, the degree of malignancy is high, the growth is fast, and the infiltration is strong. It often affects the tongue muscles, which restricts the tongue movement, making it difficult to speak, eat and swallow. Tongue cancer can invade the lingual palatine arch and tonsils, and advanced tongue cancer can spread to the floor of the mouth and jawbone to fix the entire tongue. Severe pain often occurs with secondary infections or cancer of the root of the tongue, and radiates to the ipsilateral head and face. Because the tongue has abundant lymphatic vessels and blood circulation, and the tongue has frequent mechanical movements, tongue cancer metastasizes earlier and has a higher probability of metastasis. Cancers of the back of the tongue or across the midline of the tongue can metastasize to the contralateral cervical lymph nodes; cancers in the front of the tongue mostly metastasize to the submandibular and deep cervical lymph nodes, and the middle group; the tip of the tongue can metastasize to the submental or directly to the neck In the middle group of lymph nodes, the cancer of the tongue root not only metastasizes to the submandibular or deep cervical lymph nodes, but also may metastasize to the lymph nodes behind the styloid process and the posterior pharynx. Tongue cancer can also develop distant metastasis, usually more to the lungs.

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