2/16/16 Head and neck tumors/parotid Flashcards
Most common benign parotid tumor; stellate and spindel cells with myxoid background
Pleomorphic Adenoma
- may have papillary cysts and mucoid fluid and nodules of lymphoid tissue
Most common malignant parotid tumor; mucus-secreting cells and epidermoid cells
Mucoepidermoid Carcinoma
- may invade facial nerve
- TX: radical parotidectomy with facial nerve sacrifice
- Do neck dissection when high-grade or with adenopathy
- Radiation if high-grade
Most common submandibular tumor
Adenoid cystic carcinoma
Treatment of sublingual and minor salivary tumors
- surgery +/- XRT
- 75% are malignant
- consists of less than 10% of all salivary tumors
Treatment of lip cancer
- surgery or XRT
Tongue cancer treatment
- surgery versus RT if early
- surgery if >3mm or poorly differentiated
Treatment hypopharyngeal or laryngeal merkel cell
- REMEMBER: Merkel cell cancers are aggressive and have high recurrence rates
- 2-3 CM margin, SLNBx, post-op XRT, chemo
Indications for XRT in the mouth
- T4 or T3
2. positive or 3cm
Local options for oropharyngeal reconstruction
Tongue (20-40% can be used as a donor), nasolabial, masseter flaps
Options for oropharyngeal reconstruction
Axial: forehead, superficial temporal, temporalis, deltopectoral, FAMM
MuscCut: Pec major, Lat, SCM, Platysma, Trapezius, Serratus anterior
Risk factors for osteoradionecrosis
- radiation >6400 cGy
- Dental Caries
- Extractions
TX: surgical resection and hyperbaric oxygen therapy
ALT flap
vessel: Descending branch of the lateral femoral circumflex
nerve: lateral femoral cutaneous
Most common salivary gland tumor in children
hemangioma
- benign
- rapid growth age 1-6 months followed by gradual involution over 1-12 years
