Head and Neck Cancer

Question 1

why are swellings in the neck dangerous?

Answer 1

lots of compressible soft structures

- e.g carotid arteries

Question 2

describe the step-wise approach to investigation in neck swellings

Answer 2

US (shows type)
FNA
CT
MRI (deep lobe)
PET (metastatic nodes)

Question 3

what are the benefits of US?

Answer 3

no radiation
quick
assesses lymph nodes in the neck
can guide FNA

Question 4

what is a CT scan good for?

Answer 4

can assess local extent
quick
high sensitivity in detection of bony erosion or destruction and pulmonary metastases

Question 5

benefits of MRI?

Answer 5

superior soft tissue contrast
assesses spread and local nodes
evaluates perineural spread
better than CT for identifying marrow involvement

Question 6

drawbacks of MRI?

Answer 6

less sensitive than CT for cortical erosion
longer examination time
contraindicated in pacemakers and aneurysm clips