Tumors of the tongue affect cats and dogs, but are uncommon.

Some tumors are benign yet others can be malignant.

Tongue masses often do not cause noticeable functional problems, therefore an owner may not be aware of the problem until the tumor is large and visible.

Dogs can function quite well with removal of a significant portion of the tongue.

What is it?

• The tongue can develop a mass due to
  • Trauma to the tongue causing blood accumulation in the tongue (hematoma)
  • Non-cancerous growths such as viral papillomas (warts)
  • Calcium deposits in the tongue (calcinosus circumscripta)
  • Cancerous tumors of the tongue
    • Benign (non-cancerous):
      • Hematomas (blood clot in the tongue)
      • Granular Cell Myoblastoma
    • Cancerous masses:
      • Squamous Cell Carcinoma
      • Mast Cell Tumor         
      • Fibrosarcoma
      • Malignant melanoma – may be pigmented or nonpigmented (amelanotic)
      • Hemangiosarcoma
      • Other sarcoma-type masses may be seen

Anatomy

• The tongue is composed of a number of muscles which work together to move the tongue in any direction. 
• The tongue is a muscular organ that is attached to the lower aspect of the mouth by a loose tissue called the frenulum. 
• The tongue originates beyond the angle of the jaw in the upper portion of the throat near the vocal cords. 
• The end of the tongue is free to move in any direction and assists in drinking (lapping of water), holding food within the mouth for chewing (prehension), and grooming. 
• The tongue is covered by a variety of finger-like structures which aid in the holding of food, grooming, and tasting. 
• In dogs, the tongue is used to help control body temperature; the body is cooled when panting, which then cools the entire body (like a radiator on a car).
  
• The tongue is supplied by a large number of blood vessels and nerves.  External damage to the tongue results in a large amount of bleeding due to the large amount of muscle and the significant blood supply to the tongue.

Clinical Signs

• Signalment:
  • Breeds:  No particular breed is over-represented
  • Age:  Middle age to older pets
  • Sex:  same frequency in males and females
• Signs:
  • Increased salivation (ptyalism)
  • Bad odor from the mouth
  • Pawing at the mouth
  • Dropping food while eating or having difficulty eating
  • Not eating (anorexia)
  • Loosing weight
  • Not playing with toys, chewing bones
  • Blood coming from mouth or blood-tinged saliva
  • Breathing difficulty
  • Mass seen on the tongue (see photos above and below)

Diagnosis

• Physical examination will often reveal a growth or ulcer on the tongue (see photo right).
• Collecting samples for cellular analysis (fine needle aspirates) are often difficult and unrewarding, thus collecting a tissue sample (core or wedge biopsy) is the preferred method to determine the type mass affecting the tongue.
• Additional tests to evaluate a patient that has a tumor of the tongue includes
  • Complete blood count
  • Chemistry profile
  • Urinalysis
  • Chest radiographs (x-rays)
  • Fine needle biopsy of enlarged lymph nodes

Treatment

• Surgery – simple mass removal is used for benign tumors, however, radical surgery is used for invasive or malignant tumors
  • Resection of the local mass using a wedge-shaped incision may be performed (see photo right).
  • Hemiglossectomy – removal of half of the tongue may be recommended.
  • Total glossectomy – removal of the entire tongue may be recommended.
• Additional therapies may be recommended depending on the type of tumor identified
  • Chemotherapy
  • Radiation therapy
               
    

Post-operative Care

• Absorbable sutures are placed in the tongue and will dissolve without further care.
• Some blood-tinged saliva may be noticed for the first few days following the surgery, but this should resolve.  There should not be active bleeding or hemorrhage from the mouth noted at any time. 
• Canned food or softened food may be recommended for up to two weeks to allow complete healing of the area depending on the extent of surgery performed.
• Dogs that have a radical resection of the tongue may need to be hand fed initially. A deep pail of water is needed so that they can drink. Dogs will learn to dunk the face into the water pail and then throw the head upwards to consume the water. If a dog is unable to learn how to eat and drink (this is unusual), then a feeding tube may be placed in the stomach or esophagus to permit feeding by the owner.

Potential Complications

• Anesthetic reaction: mortality is possible, but is an uncommon problem under the care of of specialists. We use modern anesthetic medications and monitor our patients closely during the entire anesthetic period.
• Infection:  the tongue heals quickly, however the mouth has a large number of bacteria and infections can occur.  Antibiotics may be used after surgery to prevent this problem.
• Wound dehiscence (opening):  the sutures that are placed in the tongue incision can get caught on the teeth or external objects such as toys and then become untied.
• Nerve damage:  depending on the extent of surgery and the location of this surgery, damage to nerves may occur making the tongue move in an unusual direction either temporarily or permanently.  Some function can return with time.
• Re-growth of the mass:  depending on the location and type cancer, some masses may recur.
  
• Spreading of cancer to other sites:  Cells may be carried by the blood stream or the lymphatic vessels to other parts of the body, so the appearance of other masses or swollen lymph nodes should be evaluated.

Prognosis

• The long-term outcome depends on the type of tumor that has been identified and its location on the tongue. It is amazing that dogs that have had a radical resection of the tongue can actually eat and drink quite well, following a time of adaptation.
• Surgery can be curative in some cases, especially those that are located on the tip of the tongue.