Head and neck cancers Flashcards
where can head and neck cancers arise from?
- oral cavity
- pharynx
- larynx
- paranasal sinuses
- nasal cavity/salivary glands
what is the main type of cancer?
90% squamous cell carcinoma
Risk factors of head and neck cancers?
- alcohol and tabacco use
2. HPV
how do premalignant conditions present?
may begin as visible premalignant condition
1. leukoplakia - white patches
2. erythroplakia - red patches
risk of transforming
How does oral cavity cancer present?
- painless mass on the inner lip, tongue or hard palate (URGENT)
- premalignant lesions may be seen first (erythro/leukoplakia) (URGENT)
- oral bleeding, jaw pain or swelling
How do pharyngeal cancers present?
- Odynophagia
- dysphagia
- referred otalgia
- neck lump
What does trotters syndrome show?
triad of clinical features suggestive of nasopharyngeal malignancy
- unilateral conductive deafness
- trigeminal neuralgia
- defect in the mobility of the soft palate
How does laryngeal cancer present?
- hoarse voice + unexplained lump in neck (URGENT)
- stridor
- dysphagia
- persistent cough
- otalgia
How can head and neck cancer present with ear pain?
Tonsil area is supplied by the glossopharyngeal nerve
irritation of glossopharyngeal nerve can result in refereed pain via Jacobson’s nerve (tympanic branch of the glassopharyngeal nerve) to the ear
which cancers can present with referred otalgia?
- laryngeal
2. pharyngeal
Name other common causes of referred otalgia?
- dental pathology
- pharyngitis
- sinusitis
- cervical spine pathology
- pharyngeal abscess / parotid gland mumps
Ix of HNSCC
- flexible nasal endoscopy (FNE)
2. Biopsyte3. CT scarn for staging and MRI to assess the lesion bet
Mx
- surgical resection with adjuvant radiotherapy
or
- primary radiotherapy with adjuvant chemo
