A 59-year-old woman has discomfort in the posterior part of her tongue. A biopsy confirms that the lesion is a carcinoma. What is true in carcinoma of the posterior third of the tongue?
**Core Concept**
Carcinoma of the posterior third of the tongue is a type of oral cancer that originates from the squamous epithelium of the tongue. This type of cancer is often associated with poor prognosis and limited treatment options due to its location and late-stage diagnosis.
**Why the Correct Answer is Right**
Carcinoma of the posterior third of the tongue is often associated with a higher risk of lymph node metastasis, particularly to the jugular lymph nodes. This is because the lymphatic drainage of the posterior tongue is primarily to the jugular chain, making it more challenging to detect and treat lymph node metastasis. The involvement of the tongue's root and the base of the tongue can also lead to invasion into adjacent structures, such as the epiglottis, vallecula, and hyoid bone.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because the anterior two-thirds of the tongue is more commonly associated with squamous cell carcinoma, whereas the posterior third is more commonly associated with other types of cancer, such as verrucous carcinoma and mucoepidermoid carcinoma.
**Option B:** This option is incorrect because the primary treatment for carcinoma of the posterior third of the tongue is surgical resection, often followed by radiation therapy and/or chemotherapy, rather than palliative care alone.
**Option C:** This option is incorrect because the involvement of the tongue's root and the base of the tongue is a characteristic feature of carcinoma of the posterior third of the tongue, which can lead to invasion into adjacent structures and poor prognosis.
**Clinical Pearl / High-Yield Fact**
The posterior third of the tongue is a common site for verrucous carcinoma, a type of low-grade squamous cell carcinoma that is often associated with a more favorable prognosis than other types of oral cancer.
**Correct Answer:** C.