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Tongue Biopsy

Last updated May 2, 2019

Approved by: Krish Tangella MD, MBA, FCAP


Biopsy of tongue showing benign hemagioma.

Background Information:

What are the other Names for the Procedure?

  • Biopsy of Tongue

What is the Tongue Biopsy surgical procedure?

  • Tongue Biopsy is a procedure that involves the removal (either a portion or complete removal) of any abnormality present on the tongue
  • The removed tissue is then examined in a pathology laboratory to identify any pre-cancerous abnormality or to diagnose oral cancer (cancer of the tongue)

What part of the Body does the Procedure involve?

A Tongue Biopsy procedure involves the tongue.

Why is the Tongue Biopsy surgical procedure Performed?

A Tongue Biopsy is performed for the following reasons:

  • To investigate if abnormal lesions (or growth) within the tongue are cancerous
  • Removal of abnormal tongue tissue, which is then sent to a pathologist for examination

What are some Alternative Choices for the Procedure?

There are no alternatives to a biopsy when it comes to making a definitive diagnosis of cancer.

What are the Recent Advances in the Procedure?

There are no recent advances to the biopsy procedure.

What is the Cost of performing the Tongue Biopsy surgical procedure?

The cost of Tongue Biopsy procedure depends on a variety of factors, such as the type of your health insurance, annual deductibles, co-pay requirements, out-of-network and in-network of your healthcare providers and healthcare facilities.

In many cases, an estimate may be provided before the procedure. The final amount depends upon the findings during the surgery/procedure and post-operative care that is necessary.

When do you need a Second Opinion, prior to the Procedure?

  • It is normal for a patient to feel uncomfortable and confused by the information regarding the Tongue Biopsy on what needs to be done
  • If the patient needs further reassurance or a second opinion, a physician will almost always assist and also recommend another physician, if required
  • Also, if the procedure involves multiple surgeries or has many alternatives, the patient may take a second opinion to understand and choose the best one. They can also choose to approach another physician independently

What are some Helpful Resources?

Complete Guide to Symptoms, Illness & Surgery; Written by H Winter Griffith, M.D.; Revised and updated by Stephen Moore, M.D. and Kenneth Yoder, M.D.; The Berkley Publishing Group, 5th Edition, New York, 2006

http://www.jcda.ca/article/c75 (accessed on 05/15/2015)

Prior to Tongue Biopsy surgical procedure:

How is the  Tongue Biopsy surgical procedure Performed?

A Tongue Biopsy procedure is performed after numbing the area with local anesthesia.

  • A sample of tissue is obtained by either cutting out a small portion of the diseased area (incision biopsy), cutting out the lesion or diseased part completely (excision biopsy), or by using a special instrument to obtain a thick sample from the center of the diseased portion (punch biopsy)
  • Any defect caused by the incision or excision technique is then sutured

Where is the Procedure Performed?

A Tongue Biopsy is usually performed in an out-patient surgery center facility, a physician’s clinic or office, a dentist or oral surgeon’s clinic or office, or in a hospital.

Who Performs the Procedure?

The Biopsy of Tongue is performed by any of these medical personnel, with or without assistance from an anesthesiologist:

  • General surgeon
  • Dentist
  • Oral surgeon

How long will the Procedure take?

The Biopsy of Tongue procedure usually takes about 20-30 minutes.

What do you need to tell your Physician before the Procedure?

It is very important to provide the following information to your healthcare provider. This enables your healthcare provider in assessing the risks for the Tongue Biopsy procedure and helps avoid unnecessary complications.

  • Provide a complete list of medications you are currently taking to your physician. This information is useful for a variety of reasons. For example, it can help your healthcare provider prevent complications due to a drug interaction
  • If you are allergic to any specific medication or food items
  • If you are taking blood thinners such as aspirin, warfarin, herbal supplements, or any other such medications
  • If you or your family members have a history of bleeding disorders, or if there is a tendency to bleed more than normal
  • If you have diabetes, high blood pressure, chest pains, or have previously suffered from a heart attack
  • If you have ever been diagnosed with blood clots in your leg (deep vein thrombosis) or lung (embolism of lung)
  • If you have a history of frequent bone fractures (this may affect bone-healing if bones are involved as part of your procedure)
  • A list of all previous surgical procedures you have undergone, like for example: Removal of appendix, gallbladder, or any other part of your body; surgical repair of any body part, such as hernia repair, perforation of bowel wall, etc.

What Preparations are needed, prior to the Procedure?

  • The physician may evaluate the individual’s medical history to gain a comprehensive knowledge of the overall health status of the patient including information related to the medications that are being currently taken
  • Some medications increase a person’s chances of bleeding, and it may be recommended to discontinue them for a period of time before the procedure is performed
  • Blood tests may be performed to determine if there is a bleeding tendency or any other medical conditions that prevents the person from undergoing the procedure
  • Do inform the physician if you are allergic to any local anesthetics, lidocaine, etc.
  • Avoid application of any cosmetics, deodorant, or topical medicines on the area prior to the procedure
  • It is advisable to quit smoking and the use of any nicotine based products for a while before the surgery
  • Consumption of alcoholic drinks must also be avoided for a period of time, as instructed
  • For persons suffering from diabetes, it is important that the blood sugar stays within the normal range; if not, their diabetologist may have to control blood sugar by recommending insulin and/or a combination of oral medicines

What is the Consent Process before the Procedure?

A physician will request your consent for Tongue Biopsy procedure using an Informed Consent Form.

Consent for the Procedure: A “consent” is your approval to undergo a procedure. A consent form is signed after the risks and benefits of the procedure, and alternative treatment options, are discussed. This process is called informed consent.

You must sign the forms only after you are totally satisfied by the answers to your questions. In case of minors and individuals unable to personally give their consent, the individual’s legal guardian or next of kin, shall give their consent for the procedure.

What Tests are needed, before the Tongue Biopsy surgical procedure?

Before a Tongue Biopsy procedure, the patient may need to undergo certain tests (as directed by the physician) such as:

  • Routine blood and urine analysis
  • Computerized tomography (CT) scan, if required
  • Magnetic resonance imaging (MRI) scan, if required

What are some Questions for your Physician?

Some of the basic questions that you might ask your physician are as follows:

  • What is a Tongue Biopsy?
  • Why is this procedure necessary?  How will it help?
  • How soon should I get it done? Is it an emergency?
  • Who are the medical personnel involved in this procedure?
  • Where is the procedure performed? 
  • What are the risks while performing the procedure?
  • What are the complications that might take place during recovery?
  • How long will it take to recover? When can I resume normal work?
  • How many such procedures have you (the physician) performed?
  • Are there any follow-up tests or periodic visits to the healthcare facility required after the procedure?
  • What are the costs involved?

During the Tongue Biopsy surgical procedure:

What kind of Anesthesia is given, during the Procedure?

Local anesthesia by injection may be administered for the Tongue Biopsy procedure.

How much Blood will you lose, during the Procedure?

Tongue Biopsy is a minimally-invasive procedure; there is little or no blood loss involved.

What are the possible Risks and Complications during the Tongue Biopsy surgical procedure?

There are general factors that increase the risk of getting complications during surgery and they include:

  • Obesity: Generally, the greater the degree of obesity, the greater the surgical risk
  • Smoking: The longer the smoking history (in pack years smoked), the greater the surgical risk
  • Advancing age
  • Poorly controlled diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose
  • Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine
  • Poorly functioning liver, as evidenced by increased blood liver function tests
  • Hypertension (increased blood pressure), especially if it is poorly controlled
  • Poor nutritional status (malnutrition with mineral and vitamin deficiencies)
  • Poor lung function, as evidenced by abnormal lung function tests
  • History of bleeding disorders
  • Longstanding illness such as autoimmune disorders or chronic infections
  • Poor immune system due to a variety of causes

The possible risks or complications that may arise during the Tongue Biopsy are:

  • Excessive bleeding
  • Infection within the surgical wound
  • Anesthetic complications

What Post-Operative Care is needed at the Healthcare Facility after the Tongue Biopsy surgical procedure?

At the healthcare facility, usually there is no requirement for any post-procedure care, unless any complications arise.

After the Tongue Biopsy surgical procedure:

What are the possible Risks and Complications after the Tongue Biopsy surgical procedure?

Post Tongue Biopsy, the following complications may arise:

  • Excessive bleeding
  • Infection within the surgical wound

What is the Prognosis after the Surgery?

The biopsy procedure does not involve any significant tissue destruction. Hence, recovery from it is generally excellent.

When do you need to call your Physician?

Do contact your physician if you notice any of the following symptoms:

  • Worsening pain within the surgical wound
  • Bleeding or fluid drainage from the surgical wound
  • Signs of an infection
  • Fever, feeling sick
  • Dizziness
  • Complications associated with prescription medications used in treatment

What Post-Operative Care is needed at Home after the Tongue Biopsy surgical procedure?

At home, the following post-operative care is recommended after a Tongue Biopsy procedure:

  • Rinse mouth with warm salt-water to relieve any discomfort
  • Use a soft toothbrush to brush your teeth
  • Complete the course of prescribed medication under advice of the physician
  • Take antibiotic medication to help combat or prevent infection (per the physician’s advice)
  • Avoid taking nonprescription medications such as aspirin. However, individuals may take acetaminophen to relieve pain, per the physician’s advise
  • Resume daily food and fluid intake after the procedure, which will result in a faster healing process. If normal daily diet seems difficult at first, attempting a high-protein liquid diet for a few days might be helpful

How long does it normally take to fully recover, from the Procedure?

A complete recovery from the biopsy procedure usually takes a few days, depending on the technique used.

Additional Information:

What happens to tissue (if any), taken out during the Procedure?

The tissue is taken for further examination and later disposed as per the standard medical procedure.

When should you expect results from the pathologist regarding tissue taken out, during the Procedure?

  • The tissue removed is processed in the laboratory under a pathologist's supervision
  • Slide(s) are prepared once the tissue is processed and is examined by a pathologist and a pathology report issued
  • Depending on the complexity of the case, issue of the report may take anywhere between 72 hours to a week's time

Who will you receive a Bill from, after the Tongue Biopsy surgical procedure?

It is important to note that the number of bills that the patient may receive depends on the arrangement the healthcare facility has with the physician and other healthcare providers.

Sometimes, the patient may get a single bill that includes the healthcare facility and the consultant physician charges. Sometimes, the patient might get multiple bills depending on the healthcare provider involved. For instance, the patient may get a bill from:

An out-patient surgery center facility, the physician’s clinic or office, a dentist or oral surgeon’s clinic or office, or from a hospital

  • A general surgeon, dentist, or an oral surgeon
  • An anesthesiologist (if anesthesia was administered)
  • A pathologist

The patient is advised to inquire and confirm the type of billing, before the Tongue Biopsy procedure is performed.

Thanks and Gratitude:

We sincerely acknowledge and thank Dr. Douglas J. Jones for reviewing the article. His valuable input and feedback has helped enrich the contents of this article.

Douglas J. Jones, MD FACS
Board Certified General Surgeon and Faculty Member
University of Illinois, College of Medicine at Urbana-Champaign
506 S. Mathews Ave., Urbana, IL 61801, USA

Reviewed and Approved by a member of the DoveMed Editorial Board
First uploaded: May 27, 2015
Last updated: May 2, 2019