Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ENT > ENT neoplasms > Flashcards

ENT neoplasms Flashcards

1
Q

Epidemiology of ENT neoplasms?

A
  • male to female ratio: 2:1 to 4:1
  • US: 3% of malignancies
  • 12,000 Americans die and 60,000 develop these neoplasms annually
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

RFs of ENT neoplasms?

A

smoking

  • 5-25 fold increase compared to non-smokers
  • 2ndhand smoke exposure
  • marijuana use maybe

alcohol: may have assoc with smoking

viral infection:
EBV - most common in S. China
HPV: HPV type 16, usually seen in younger men who are nonusers of tobacco or alcohol
HIV: 2-3x increase risk for SCC

occupational exposure: dry cleaning agents, pesticides, plastic and rubber products

radiation: assoc with thyroid cancer, salivary gland tumors, SCC, sarcomas

poor oral hygiene and periodontal disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Mucosal oral tumors?

A
  • leukoplakia
  • erythroplakia
  • oral lichen planus
  • oral carcinoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Salivary gland tumors?

A
  • parotid
  • warthin’s tumor
  • pleomorphic adenoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is leukoplakia?

A
  • precancerous lesion that presents as white patches or plaques on oral mucosa that can’t be removed by rubbing
  • b/t 1-20% of lesions progress to carcinoma within 10 years
  • common in smokeless tobacco users
  • bx to rule out SCC
  • distinguished by thrush - white patches can’t rub off
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is erythroplakia?

A
  • similar to leukoplakia except it has red erythematous component
  • 90% cases are dysplasia or carcinoma
  • ETOH/tobacco risk factors
  • need bx to confirm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is oral lichen planus?

A
  • chronic inflammatory autoimmine disease
  • presentation: lace like white patches on buccal mucosa, erosions on gingival margin
  • exfoliative cytology or bx
  • therapy aimed at managing pain and discomfort: corticosteroids
  • good dental hygiene, going to dentist regularly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Oral cancer - Mostly what?

most common locations?

A
  • 90% of all oral cancers are SCC
  • most common locations:
    tongue
    tonsils
    gums
    floor of mouth
  • 8th most common cancer in men
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Signs and sxs of oral cancer?

A
  • most common is sore in mouth that doesn’t heal
  • red or white patch in mouth
  • persistent sore throat or something caught in throat
  • hoarseness or change in voice
  • chronic halatosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Dx oral cancer?

A
  • good hx for RFs
  • exam: close inspection of oral cavity
  • endoscopy
  • bx: FNA, open bx, oral brush
  • CT/MRI/US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx of oral cancer?

A
  • surgery
  • radiation: sometimes in combo or primary tx, used for pts who can’t undergo surgery or surgery causes severe impairment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Most common sites for salivary gland tumors?

A
  • parotids: 80-85%
  • submandibular: 40-45%
  • sublingual: 70-90%
  • 50-70% minor salivary glands
  • most common type of benign salivary gland tumor is pleomorphic adenoma (parotid)
  • MC type of malignant tumors include mucoepidermoid carcinoma and adenoid cystic carcinoma
  • rare tumor, 6-8% of head and neck tumors
  • 2000-2500 cases/yr in US
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

RFs of salivary gland tumors?

A
  • radiation exposure
  • smoking: warthin’s tumor only salivary tumor assoc with smoking
  • virus infection: HIV, EBV
  • industrial exposure: rubber manufacture, hair dressers, nickle compounds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Presentation of salivary gland tumors?

A
  • painless mass or swelling of salivary glands
  • minor salivary glands arising within oral cavity present:
    sub-mucosal mass, mucosal ulceration of palate, lips or buccal mucosa
    depending on location:
    nasal obstruction
    congestion
    vision changes
    trismus
    (have face paralysis and other involvement - think malignant)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Work up: PE of salivary gland tumor, studies done?

A
  • workup:
    good hx about mass - how long has it been there? Getting bigger? any hx of skin cancer (SCC/melanoma)
    PE:
    impt close inspection of oral cavity, palpation of neck, facial nerve paralysis - have pt make faces at you!
    imaging:
    CT/MRI/US: with warthin tumor need to image both parotid glands, tendency to be bilateral (look for mass on otherside if found on one side)
  • bx: FNA cytology, US guided core bx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Tx of salivary gland tumors? parotid gland tumor tx?

A
  • usually surgery, radiation or combo

parotid gland: depends on size, involvement, benign, malignant, or facial involvement
- conservative: partial parotidectomy w/o fully dissecting facial nerve
- superficial: parotidectomy of entire superficial lobe and dissection along facial nerve
- total: removal of entire lobe and surrounding tissue with preservation of facial nerve (high grade tumor)
- benign:
superficial resection - pleomorphic adenomas
conservative - warthin’s tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Tx of submandibular gland tumor?

A
  • submandibular sialoadenectomy and resection of submandibular gland
  • benign: simple excision of gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Sublingual gland tumor tx?

A
  • resection of floor of mouth and involved sublingual gland, as well as ipsilateral submandibular gland
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Minor salivary gland tumor tx?

A
  • surgical resection with radiation preferred
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How common are pleomorphic adenomas?

Dx tests, tx?

A
  • 3-6% of all head and neck tumors
  • most common benign tumor of parotid (53-71%)
  • slowly growing, painless, solitary, firm, smooth, moveable mass without nerve involvement
  • CT/MRI/FNA
  • superficial parotidectomy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe warthin’s tumor?

A
  • 2nd most common benign tumor
  • tendency to be bilateral, parotid gland only
  • older age group
  • superficial location
  • smoking is a RF: only salivary gland tumor with this risk factor (foot stomp)
  • conservative resection
22
Q

How common are nasal and sinus tumors?

A
  • cancerous nasal cavity or sinus tumors are rare
  • about 2000 cases diagnosed in US each year
  • most of these tumors occur in maxillary sinus (60-70%)
  • 20-30% are in nasal cavity
  • 10-15% are in ethmoid sinuses
  • cancer in sphenoid or frontal sinuses is extremely rare (5% of cancers)
23
Q

Causes and RFs of nasal and sinus tumors?

A
  • smoking and tobacco smoke
  • exposure to dust from wood
  • leather or textiles
  • inhaling vapors from glue
  • formaldehyde
  • solvents
  • nickel
  • HPV
24
Q

Signs and sxs of nasal and sinus tumors?

A
  • persistent nasal congestion, especially on one side
  • pain in forehead, cheek, nose or around eyes or ear (double or blurred vision)
  • post-nasal drip at back of throat
  • frequent and persistent nosebleeds
25
Q

Dx of nasal and sinus tumors?

A
  • medical hx and PE of head and neck
  • small fiberoptic scope may be used to look in the nasal cavity and sinuses
  • bx:
    FNA, open bx
  • CT/MRI/PET
26
Q

Tx of nasal and sinus tumors?

A
  • surgery:
    +/- radiation or chemo
  • radiation
  • chemo
27
Q

Malignant nasal and sinus tumors?

A
  • SCC: most common
  • adenocarcinoma: occurs in sinus lining
  • lymphomas
  • esthesioneuroblastomas: develop from nerves at base of skull where they enter the nasal cavity and provide sense of smell
28
Q

Benign nasal and sinus tumors?

A
  • osteomas: usually don’t cause sxs, but can impede the frontal, ethmoid or maxillary sinuses, if it does cause obstruction it will need to be removed surgically
  • viral infections:
    HPV - can cuase papillomas - wart like growths in the nose or sinus, 10% are cancerous, most are benign
29
Q

How is nasopharyngeal cancer different than other pharyngeal cancers?

A
  • much more common with Asians and SE Asian populations
  • strongly correlated wth EBV
  • some types are highly radiosensitive and radiotherapy is the preferred tx
  • most nasopharyngeal cancers are SCC
30
Q

Keratinizing form of nasopharyngeal cancer?

A
  • well-differentiated cells that produce keratin:
    more common in US, less in Asia
  • less assoc with EBV
  • may be assoc with tobacco use
  • less radiosensitive and more radio resistant
  • doesn’t tend to met
31
Q

Non-keratinizing nasopharyngeal cancer?

A
  • tends to met to regional lymph nodes
  • variable radiosensitivity
  • often linked to EBV infection
32
Q

Undiff subtype nasopharyngeal cancer?

A
  • often occurs in conjunction with high numbers of lymphocytes
  • more common in Asia
  • most often assoc with EBV
  • tend to met to regional lymph nodes
  • very radiosensitive
33
Q

Signs and sxs of pharnygeal tumors?

A
  • lump in nose or neck
  • sore throat
  • trouble breathing or speaking
  • nosebleeds
  • trouble hearing
  • pain or ringing in the ears
  • HAs

(triad: lump in nose or neck, nasal obstruction with nose bleeds, and serious otitis media)

34
Q

Oropharyngeal cancer - most common type?

Areas for cancer?

A 
- most are SCC
 areas:
-base of tongue
-tonsillar region: most common site for primary cancers of oropharynx 
- soft palate/uvula
- pharyngeal wall
35
Q

RFs of oropharyngeal tumors?

A
  • tobacco (both chewed and smoked)
  • poor nutrition
  • heavy ETOH consumption
  • Eastern Asian descent
36
Q

Signs and sxs of oropharyngeal tumors?

A
  • sore throat that doesn’t go away
  • lump in back of mouth, neck, or throat
  • dull pain behind breastbone
  • cough
  • trouble swallowing
37
Q

Hypopharyngeal tumor - most common type?

RFs?

A
  • least common type of pharyngeal cancer
  • SCC MC type
- RFs:
excessive drinking
smoking
male gender
poor nutrition
HPV
38
Q

Signs and sxs of hypopharyngeal cancer?

A
  • sore throat that doesn’t go away
  • ear pain
  • lump in neck
  • painful or difficulty swallowing
  • change in voice
39
Q

Dx pharyngeal tumors?

A
  • Hx and PE
  • head, neck and CXRs
  • CT/MRI/PET
  • endoscopy
  • bx: FNA, open bx
  • HPV testing
40
Q

Dx specific for nasopharyngeal cancer?

A
  • nasoscopy

- EBV test

41
Q

Dx specific for hypopharyngeal cancer?

A
  • barium esophagogram
  • esophagoscopy
  • bronchoscopy
42
Q

Tx of pharyngeal tumors?

A 
- surgery mainstay for most
exceptions:
nasopharyngeal cancer - primarily tx with radiation, keratinizing form is much less responsive to radiation than non-keratinizing forms, so these benefit from surgery
- radiation: alone or with chemo
- chemo
43
Q

MC type of laryngeal tumors?

A
  • 95% are SCC
  • most commonly arise from glottic region (vocal cords)
  • majority of pts have hx of smoking and ETOH use
44
Q

4 subtypes of laryngeal tumors?

A
  • glottic carcinoma: involves true vocal cords (50-60%)
  • supraglottic carcinoma: confined to supraglottic area (30-40%)
  • subglottic carcinoma: arise more than 10 mm below free margin of vocal cords (5%)
  • transglottic carcinoma: cross ventricle from supraglottic area to involve true and false vocal cords
45
Q

Other laryngeal cancers?

A
  • carcinoma in situ
  • verrucous (spindle cell and basaloid SCC)
  • undifferentiated carcinoma
  • adenocarcinoma
  • sarcomas
46
Q

RFs of laryngeal tumors?

A
  • tobacco/ETOH
  • poor diet and oral hygiene
  • HPV
  • GERD (changes in cells from acid reflux)
  • asbestos
  • formaldehyde
47
Q

How common are laryngeal tumors? What pt population are they most common in?

A
  • comprises of 2-5% of all malignant disease
  • highest in med aged 55-65
  • male to female ratio:
    5-20:1
48
Q

Presentation of laryngeal tumors?

A
  • progressive continuous hoarseness is cardinal sx
  • dyspnea
  • stridor
  • dysphagia
  • bad breath
  • hemoptysis
  • (also worry about lung cancer)
49
Q

Workup of laryngeal tumors?

A
  • CT/MRI/PET
  • CXR
  • direct laryngoscopy: can obtain bx
  • FNA cytology
50
Q

Tx of laryngeal tumors?

A
  • early stages are tx with either radiation or surgical techniques to preserve laryngeal fxn
  • advanced stages are tx with total laryngectomy, reconstruction, and postop chemorad therapy

ENT (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions