Head and neck neoplasms Flashcards

1
Q

What is the most common malignant head and neck lesion

A

squamous cell carcinoma

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2
Q

Structures of oropharynx

A
  • posterior 1/3 of tongue
  • soft palate
  • lateral and posterior walls of throat
  • tonsils
  • pharynx
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3
Q

what are oral cancers associated with

A
  • non healing ulcers or masses

- dental changes of poorly fitting dentures

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4
Q

Presentation of tongue and lip cancers

A

exophytic or ulcerative lesions often associated with pain

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5
Q

Most of the pts with primary tongue lesions have disease where

A

nodal disease

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6
Q

Major risk factors for tongue and lip cancer

A

tobacco/ETOH

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7
Q

Risk factor for cancer of oropharynx

A

HPV

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8
Q

Most common malignancy of the head and neck

A

oral cavity squamous cell carcinoma

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9
Q

Where do the majority of HPV related head and neck squamous cell carcinomas arise

A

oropharynx, palatine and lingual tonsils

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10
Q

What other structure does HPV16 affect

A

posterior part of the tongue, does not produce visible lesions/discolorations

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11
Q

three categories of oropharynx cancer

A
  • carcinomas of oral cavity proper
  • carcinomas arising n oropharynx
  • carcinomas of the lip vermillion
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12
Q

What threee categories is oral cancer divided into

A
  • well differentiated
  • moderately well differentiated
  • poorly differentiated (poor outcomes)
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13
Q

Alcohol and tobacco have what kind of affect in regards to risk of oral cancer

A

synergistic effect

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14
Q

What two viruses contribute to oral cancers

A

HPV and EBV

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15
Q

What often precedes oral cavity squamous cell carcinoma

A
  • leukoplakia
  • erythroplakia
  • speckled erythroplakia
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16
Q

What often precedes head and neck cancers?

17
Q

Leukoplakia classification

A
  • hyperplasia
  • dysplasia
  • carcinoma in situ
  • carcinoma
18
Q

Erythroplakia

A
  • fiery red patch that cannot be clinically identified as anything else
  • shows evidence of high grade dysplasia, carcinoma in situ or invasive SCC
19
Q

Where do the majority of tongue lesions appear

A

lateral and ventrolateral aspects

20
Q

Most common chief complaint for oropharyngeal squamous cell carcinoma

A
  • presence of a neck mass
  • sore throat
  • dysphagia
21
Q

What often precedes invasive oral SCC

A

malignant changes of oral mucosa

22
Q

Symptoms of head/neck cancer

A
  • pain
  • otalgia
  • dysphagia
  • odynophagia
  • airway obstruction
23
Q

Signs of head/neck cancer

A
  • cervical lymphadenopathy
  • cranial neuropathies
  • decreased tongue mobility
  • fistuals
  • skin involvement
24
Q

Most common site of laryngeal cancer

A

glottis (true vocal cords)

25
Cancer where spreads to the lymph nodes early
supraglottis (epiglottis, false vocal cords)
26
Granular leukoplakia
small leukoplakic lesion with rough, granular surface on the posterior lateral border of the tongue
27
What does biopsy reveal in granular leukoplakia
early invasive squamous cell carcinoma
28
Size of stage I OC-SSCs
less than 2 cm
29
Size of stage II cancers
2-4 cm
30
Imaging for head and neck lesions
- contrast/noncontrast CT of head and neck | - additional scans to asses lesions and stage cancer
31
Major determinant of survival from head and neck lesions
HPV status of the tumor