ENT Neoplasms Flashcards
Where do most oral cancers originate?
tongue and in the floor of the mouth in the squamous cells
What virus is linked to oral cancer?
HPV
Most common oral-precancerous patches inside mouth
leukoplakia
Prognosis of oral cancer
5 yr survival for localized disease is 78%
5 yr survival for metastatic disease is 19%
Percent of neck masses that are malignant
80% in adults are malignant
20% in children are malignant
When might you want to take out cervical lymph nodes with carcinoma of the lip?
if you have a poorly differentiated, locally recurrent and size > 2 cm or they are palpable
Sx of buccal mucosa carcinoma
Painless lesion in early stages and then maybe “ear pain”. Slow growing mass on buccal mucosa
Operation involving resection of half the mandible w/floor of mouth and block dissection of the neck to remove lymphatics/SCM/IJ
commando operation for extensive cheek cancer
Way is oral cancer particularly dangerous?
high risk of producing second, primary tumors. patients who survive a first encounter with the disease, have up to a 20 times higher risk of developing a second cancer
Sx of anterior carcinoma of tongue
Hyperkeratosis, pain w/speech and swallowing difficulties, 40% w/nodes on presentation
Differences of posterior carcinomas of the tongue
Higher grade, spreads rapidly, worse prognosis
Sx of posterior carcinomas of the tongue
bad breath, weight loss, cervical lymph node with pain on swallowing
Sx include soar, larger tonsil on one side, blood in saliva, mouth pain, persistent soar throat, bad breath, pain with swallowing, ear pain
tonsil cancer
Majority of salivary gland neoplasms
Parotid: 80% overall; 80% benign
Characterization of pain associated with malignant salivary neoplasms?
painless mass in approximately 75% of patients, palpable mass arising in a salivary gland, associated with pain, and/or nerve paralysis, constant pain
Sx include Slowly growing, painless, solitary, firm, smooth, moveable without nerve involvement involving both mesenchymal/epithelial elements
pleomorphic adenoma (benign salivary tumor)
Most common of all salivary gland neoplasms
Pleomorphic Adenoma
What is Warthin’s tumor?
benign, bilateral parotid gland tumor in superficial location
Most common salivary gland malignancy
Mucoepidermoid Carcinoma
Where is an adenoid cystic carcincoma likely located?
submandibular, sublingual and minor salivary glands
What does Adenoid Cystic Carcinoma have a tendency for?
perineural invasion: facial nerve sacrifice during excisional tx
Most common sinus to have a malignant neoplasm
maxillary
Classic triad of nasal carcinoma
facial asymmetry, tumor bulge in oral cavity, nasal mass
adenocarcinomas are the 2nd most common malignant rumor in maxillary and ethmoid sinuses. what is their etiology?
Strong association with occupational exposures
Most common paranasal sinus malignancy in children
Rhabdomyosarcoma
Most common subtype of laryngeal cancer
glottic cancer 59%
How many patients with laryngeal cancer have a history of tobacco and ETOH abuse?
90%
Pathognomonic of laryngeal cancers
keratin pearls
Most common symptoms of laryngeal cancers
hoarseness
When is a patient considered cured of laryngeal cancer?
after being disease free for five years
Epidemiology of pharyngeal cancers
Chinese native > Chinese immigrant > North American native
Environmental factors implicated in pharyngeal cancers
EBV and salted fish (nitrosamines)
60 yo male smoker presents with a unilateral, asymmetric nodular 1.5 cm neck mass in the anterior triangle. His local PCP gave him a 2 week trial of antibiotics without effect. What should be done first?
physical exam followed by FNA of the node
