The tongue is the most common oral location of squa-mous cell carcinoma and can account for half of all cases. The majority affect the middle third of the lateral border and adjacent ventral surface. The dorsum is a very uncommon site and tumours arising there may be associated with precursor lesions such as lichen planus and candidal leukoplakia. Lingual tumours are often exophytic and ulceration is common. Even clinically small tumours can infiltrate deeply into the underlying muscle. With progressive growth tumours become indurated and frequently develop characteristic rolled, raised, everted margins. Infiltration of the lingual musculature may cause pain, dysphagia and dysphonia. Half of patients have regional lymph node metastases at presentation. Tumours towards the tip of the tongue drain to the submental and thence to the jugulo-digas-tric lymph node, and those located on the dorsum and lateral borders tend to involve the submandibular and jugulo-digastric nodes. Contralateral or bilateral spread is relatively common, particularly in tumours arising anteriorly.

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