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Tongue biopsy scheduled. Assuming that biopsy is a simple procedure. Am I off base in these assumptions?

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ENT Specialist
Practicing since : 1991
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I am scheduled to have a biopsy on Monday of a 2-3 cm growth at the base of my tongue, near my right tonsil. The doctor is planning to use forceps to take a few samples for pathological examination to determine if cancerous or not. I havent sought a second opinion or worried too much about the experience level of the physician (certified ENT) as my feeling is that the biopsy is a fairly simple procedure, less complicated than a tonsillectomy. Am I off base in these assumptions ?
Posted Tue, 22 May 2012 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later

Thank you for your query.

1. A superficial biopsy should not be a problem. However, it should be done under local anesthesia at least. A superficial biopsy may also miss the target tissue.

2. The tongue is a very vascular structure and can bleed profusely if the biopsy id XXXXXXX This may have to be controlled with pressure and electro-cautery. The flip side benefit of high vascularity is that it heals very quickly and well.

3. In my opinion, base tongue tumors are diagnosed late as they do not cause problems initially. The tongue also has a very XXXXXXX supply of lymphatics through which growths spread quickly across the mid-line. Hence an early biopsy is advisable. I have also seen that many patients with malignant growths have a history of painful swallowing, a foreign body sensation, hot potato voice (large masses), hemoptysis and referred ear pain. A exfoliative growth often is friable and bleeds on palpation (unless it is sub-mucosal and deeper).

4. I would also recommend a flexible or rigid endoscopy, ultrasound and an MRI neck before a biopsy. This is because the trauma, bruising and inflammation and slough (due to a biopsy) makes these non-invasive imaging tests useless for a few weeks. Any deeper extensions or regional spread can be seen. Thickness of a tongue lesion is important for treatment planning.

5. As long as your diabetes is under control, there should be no problem. You may experience soreness and altered sensations in that area for some time.

I sincerely hope that your biopsy is benign and that I have answered your query. If you have any further questions I will be available to answer them. Kindly let me know the result of your biopsy.

Above answer was peer-reviewed by
Follow-up: Tongue biopsy scheduled. Assuming that biopsy is a simple procedure. Am I off base in these assumptions? 19 hours later
Thanks very much. I am having a CT scan (with contrast) of my neck today. I went to the doctor on this originally because of sore throat and earache. The biopsy will be done under general anesthesia on Monday.
Answered by Dr. Sumit Bhatti 6 hours later

Thank you for writing back.

1. All the best for your biopsy. It is usually smooth and uneventful.

2. You should get your report in a few days.

3. Early detection of tumors is the key to successful treatment.

4. Kindly let me know the results of your scan and biopsy. This will help in suggesting further treatment.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Above answer was peer-reviewed by
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