Lingual carcinomas may appear as an exophytic mass, an infiltrative lesion , or as a painful nonhealing ulcer, usually on the lateral aspect of the tongue. However patients may occasionally be seen with a painless mass in the substance of the tongue, or areas of leukoplakia or of erythroplasia may be noted. Ear pain is also a frequent presenting complaint, owing to the innervation by the auriculotemporal and lingual nerves, both branches of the trigeminal. Smoking, alcohol, chronic trauma, and poor dental hygiene, the usual predisposing factors implicated in cancers arising elsewhere in the oral cavity, are also associated with cancers of the oral tongue, although some suggest that the linkage is not nearly as strong. Males are more commonly affected than females, usually in the fifth or sixth decade. Cancers of the oral tongue as well as the floor of the mouth have been noted to be quite common in India, attributed to the local custom of chewing the Betel leaf. Several reports may also be found of oral tongue carcinomas in teenagers and young adults. Often, there are no apparent risk factors in this population and some reports suggest that the cancers behave more aggressively in this group.
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