Head and neck cancer

Question 1

What cancers are covered by head and neck squamous cell cancer

Answer 1

Oral cavity (mouth), Pharynx (throat) and Larynx

Question 2

Which strain of HPV is responsible for head and neck cancers?

Answer 2

HPV type 16

Question 3

Where does HPV type 16 cause cancers in the mouth

Answer 3

The base of the tongue and tonsil

Question 4

How do HPV positive tumours present

Answer 4

Exophytic (growing out from the epithelium) and strawberry-like on gross inspection. Classically involves the tonsillar area and the base of the tongue (posterior third).

Question 5

How do HPV positive tumours appear on histopathological examination

Answer 5

Frequently non-keratinising, basaloid and poorly differentiated (high grade)

Question 6

Is p16 over or underexpressed in HPV positive tumours

Answer 6

Overexpressed

Question 7

What method is used to detect p16

Answer 7

Immunohistochemistry

Question 8

What method is used to detect HPV

Answer 8

In situ hybridisation

Question 9

What is the gold standard for HPV detection in head and neck tumour tissue samples

Answer 9

E6 qPCR

Question 10

What does the T stand for in pTNM classification

Answer 10

Size of the tumour (If T4 suggests there has been invasion of neighboring structures

Question 11

What does the N stand for in pTNM classification

Answer 11

Is there any lymph node metastasis

Question 12

What does the M stand for in the pTNM classification

Answer 12

Are there any distant metastases

Question 13

What’s the difference between G1 and G3/4 graded tumour cells?

Answer 13

The cells look more like normal, well differentiated tissue. G3 and G4 resemble poorly differentiated tissue.