[Dysphagia without clinically relevant pathological correlation: to exclude tumours of the floor of the mouth and the base of the tongue ultrasound diagnosis is mandatory].

In patients suffering from dysphagia, a tumour of the tongue and its base must be excluded. This is not always possible by means of endoscopy and palpation. In contrast it is possible to visualize deep-seated structures of this region by ultrasound. Unfortunately, this technique is rarely used, as shown in the cases demonstrated. We present five patients suffering from dysphagia for a long period of time (up to 30 years) where ultrasound was not performed and a tumour of the floor of the mouth and the base of the tongue was overlooked. Thus, adequate therapy was delayed, which proved to be especially relevant in three patients suffering from a malignoma. Three patients suffered from a malignant tumour of the base of the tongue. Up to two years passed between the beginning of dysphagia and the necessary surgical treatment. One of these patients even underwent psychological treatment for his symptoms. In two other patients a dermoid cyst and ectopic thyroid tissue were removed. In patients suffering from dysphagia with normal endoscopic findings and normal palpation of the neck ultrasound of the floor of the mouth and the base of the tongue is imperative. Tumours of this area can be detected early with high sensitivity and cost-effectiveness by ultrasound.