head and neck cancer Flashcards
red flags in head and neck
- neck lump
- sore throat
- difficulty swallowing
- stridor
- weight loss
- pain of swallowing
- referred ear pain
- hoarseness
- non healing ulcers
- unilateral nasal bleeding/obstruction
what type of malignancy can cause a sore throat
- pharynx
- larynx
- neck
nasopharynx cancer symptoms
- unilateral epistaxis
- unilateral nasal blockage
- mass in nasopharynx
- unilateral conductive hearing loss
- neck lump
name 1 - 8
what could a midline swelling be
- thyroid
- thyroglossal cyst
- dermoid cyst
presentation fo thyroglossal cyst
- can arise in any part of the thyroglossal tract
- contains lymphatics which may become infected
- moves with tongue
- teens
investigations of a solitary thyroid nodule
- TSH
- USS-FNA
- CT
what can be some causes of anterior triangle swellings
- lymph nodes
- branchial cysts
- salivary glands
- carotid body tumour
what to ask for cervical lymphadenopathy
- intermittent/progressive
- the duration
- fever? weight loss? night sweats? (tb?)
- cough, dyspnoea
- hoarseness
- always look for hepatosplenomegaly
investigation for cervical lymphadenopathy
- CXR
- ENT optinion
- fine needle aspiration
where do branchial cysts arise
in the upper part of anterior triangle
what would you examine submandibular glands for
- stones
- pleomorphic adenoma
what would you examine parotid gland for
- stones
- pleomorphic adenoma
- infection
what is a paraganglioma
a type of neuroendocrine tumor that forms near certain blood vessels and nerves outside of the adrenal glands
which virus is nasopharyngeal carcinoma related to
EBV
which virus is oropharyngeal carcinoma related to
HPV
presentation of oropharyngeal cancer
- dysphonia
- dysphagia
- odynophagia
- otalgia
- neck lump
- stridor
where do supra-glottic tumours drain to
superior deep cervical nodes
where do glottic tumours spread
most of them stay on the cords
-minimal lymphatic spread
where do sub-glottal tumours spread
-paratracheal nodes
how do you stage a head and neck tumour
CT neck and chest with contrast
whats gold standard for investigating a neck lump
USS with fine needle aspiration
what is MRI good for looking at
nasopharynx and tongue base
laryngeal cancer management for stage 1 and 2
- transoral laser surgery
- radiotherapy
