25245              CARCINOMA OF THE TONGUE

The patient was a man aged 61 with a history of alcoholism and peripheral neuropathy.  Eighteen months before his death he developed a carcinoma of the floor of the mouth with involvement of submandibular nodes.  This was treated by chemo-therapy and radiotherapy with some improvement, but 11 months later there was a metastasis in the right hip.  This was also irradiated but he steadily deteriorated until his death from bronchopneumonia.  At postmortem there were metastases in the liver as well as the cervical nodes.

The specimen consists of the tongue, larynx, upper trachea and associated neck structures.  The specimen has been divided in the medial sagittal plane to show a sclerosing indurated ulcer on the inferior surface of the tongue in the region of the frenum, and a further indurated ulcer 1 cm in diameter on the dorsal surface of the tongue.  There is some leukoplakia of the vocal cords and of the posterior surface of the epiglottis.  A large secondary deposit 3 cms in diameter can be seen on the reverse of the jar arising from lymph nodes on the left side of the neck adjacent to the upper pole of the thyroid.  Histology shows much radiation-induced fibrosis in the inferior surface of the tongue but there are many islands of surviving squamous cancer cells.