The relationship between the carcinoma of the tongue and the muscle by 3D imageing.

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This study removed primary squamous-cell carcinoma on the lingual margin, and visualized the sequential samples from the border area between the tumor and host as computerized three-dimensional reconstructed images to examine how the progress forms of various tumors with different invasion mechanisms are related to the intrinsic lingual muscle direction at the progress site.The tumors invaded into the lingual muscular tunics in three modes : invasion of the tumor alveolar structure with interstitial tissues, which presses muscular fibrous fascicles (Type 1), diffuse invasion of the tumor into the pores of the muscular fibrous fascicles with or without the funicular, alveolar structure formed by the tumor (Type 2), and the invasion of the tumor into muscular fibrous fascicles (Type 3).The tumors showing the Type 1 progress mode showed no relation between tumor progress form and intrinsic lingual muscle direction. Type 1 was observed in both the type 2 and 3 invasion modes, which indicates that tumors with limited invasion tend to follow the Type 1 progress mode. The tumors showing the Type 2 progress mode irregularly invaded the pores of the muscular fibrous fascicles. Some of them progressed in the same direction as that of the superficial lingual muscle. Type 2 was observed in the type 4C and 4d invasion modes, indicating that tumors with high invasion tend to follow the Type 2 progress mode. Tumors showing the Type 3 progress mode indicated that small masses consisting of the tumor cells and interstitial tissues progressed in the same direction as that of the muscular fibers in the muscular fibrous fascicles. Type 3 was observed in type 4D invasion, which suggests a relation to invasion intensity.An examination of the excision area showed that a uniform safety zone around the tumor would be necessary for Type 1. For Type 2 and 3, a wider safety zone in the direction of the lingual muscle would be necessary because the tumor tends to progress in that direction.