Staging of base of tongue carcinoma by computed tomography

Staging of carcinoma of the base of the tongue according to the system adopted by the American Joint Committee on Cancer relies on clinical examination possibly augmented by multiple biopsies. Palpation of the tongue base can be difficult without anaesthesia due to retching and vomiting. Computed tomography can, however, accurately depict the deep structures of the base of the tongue without discomfort to the patient. It can also demonstrate the nodal stations of the neck. In 12 patients with primary carcinoma of the base of the tongue the clinical staging results were compared with the CT findings. In 10 of the 12 patients there was good correlation between tumour size and location, while only 2 patients showed a 1.0-1.5 cm discrepancy in the size estimate of the primary tumour. A total of 9 enlarged lymph nodes or nodal groups were only found by CT. The majority of positive nodal stations demonstrated only by CT were in the contralateral neck. Computed tomography is a valuable complement when staging tongue base carcinomas, particularly when evaluating the neck for lymph node metastasis.