Head and Neck Neoplasia - waldron Flashcards
what is the primary type of cancer of the oral cavity, pharynx and larynx
squamous cell carcinomas (SCC)
what are the major risk factors of head/neck cancer
tobacco
alcohol
HPV (oropharyngeal cancer)
EBV (nasopharyngeal cancer)
Betel nut
sun exposure of lip carcinoma
what can cause nasopharyngeal cancer
EBV - rare in US and europe
What are signs and symptoms of head/neck cancer
location dependent
non-healing ulcer/sore
persistent mass
sore throat
hoarseness
dysphagia/odynophagia
cough
neck pass
weight loss
what is a common clinical presentation of a nasopharyngeal cancer
majority present with a neck mass (90% of patients)
chronic serous otitis media
pain
what is the clinical presentation of oropharynx cancer
chronic sore throat
referred otalgia
what are the late symptoms with oropharynx cancer
change in voice/hoarseness
dysphagia
trismus (lockjaw)
what is the presentation of posterior pharyngeal wall cancer
often asymptomatic for long period
presenting complaints: pain, bleeding, neck mass
What is the presentation of hypopharynx cancer
70-80% of pts have clinically involved cervical nodes at the time of diagnosis
when is supraglottic cancer usually diagnosed
at late stages
present with: airway obstruction, neck mass due to lymphadenopathy
what are the common symptoms with Glottic laryngeal cancer
persistent hoarseness
dysphagia
referred otalgia
chronic cough
hemoptysis
stridor
how are head and neck cancers diagnosed
biopsy
if you suspect a patient has head/neck cancer - where should they be referred
EENT
what are the different testing options for head/neck cancer
Panendoscopy
CT or MRI
PET scan
CBC, LFT’s, CMP
what are congenital neck masses
Branchial cleft cysts
thyroglossal duct cysts
vascular abnormalities
what is the typical first imaging study done for neck masses
CT scan
what test is used for tissue diagnosis of neck masses
FNA (fine needle aspiration)
how are head and neck cancers staged
TNM system
(Tumor, nodes, metastases)
what is the common treatment for early stage 1 and 2 head and neck cancer
either surgery or radiation
what is the gold standard treatment for locally advanced head/neck cancer
chemoradiotherapy
what is the 5 year survival of oral cavity and pharynx cancer
about 65% overall
what is the 5 year survival rate of laryngeal cancer
60% overall
what is the rate of development of 2nd primary of the upper aero-digestive tract cancers
3-7% / year
what is the survival rate of recurrent/metastatic head/neck cancer
9 months
what is leukoplakia
white patch on oral mucosa that cannot be scraped off
pre-cancerous
what is erythroplakia
red patch on oral mucosa
precancerous
more likely than leukoplakia to become malignant or have an invasive component
what is Hairy leukoplakia
EBV induced lesion
~always HIV-infected or severe immunocompromised patients
NOT a premalignant lesion
painless white plaque
what is the most common location for nasal/paranasal cancers
maxillary sinus
(second: ethmoid sinus)
what are risk factors for Nasal/paranasal cancers
occupational exposures (leather, textile, wood dust, formaldehyde, nickel)
air pollution
tobacco smoke
what are the most common types of nasal/paranasal cancers
50% are SCC
remainder are:
adenoid cystic carcinomas
adrenocarcinomas
mucoepidermoid carcinomas
what are the typical presentation of nasal/paranasal cancers
pain
nasal obstruction
epistaxis
chronic sinus congestion
how are nasal/paranasal cancers diagnosed
biopsy
workup: endoscopy, CT, MRI
how are nasal/paranasal cancers treated
surgery and radiation
no randomized trails for treatment of these cancers
what is the prognosis/5-year survival for paranasal/nasal cancers
poor prognosis
majority of deaths due to local invasion
< 50%
What is the most common salivary gland tumor
parotid gland: benign
