Head and neck neoplasms Flashcards
What is the most common malignant head and neck lesion
squamous cell carcinoma
Structures of oropharynx
- posterior 1/3 of tongue
- soft palate
- lateral and posterior walls of throat
- tonsils
- pharynx
what are oral cancers associated with
- non healing ulcers or masses
- dental changes of poorly fitting dentures
Presentation of tongue and lip cancers
exophytic or ulcerative lesions often associated with pain
Most of the pts with primary tongue lesions have disease where
nodal disease
Major risk factors for tongue and lip cancer
tobacco/ETOH
Risk factor for cancer of oropharynx
HPV
Most common malignancy of the head and neck
oral cavity squamous cell carcinoma
Where do the majority of HPV related head and neck squamous cell carcinomas arise
oropharynx, palatine and lingual tonsils
What other structure does HPV16 affect
posterior part of the tongue, does not produce visible lesions/discolorations
three categories of oropharynx cancer
- carcinomas of oral cavity proper
- carcinomas arising n oropharynx
- carcinomas of the lip vermillion
What threee categories is oral cancer divided into
- well differentiated
- moderately well differentiated
- poorly differentiated (poor outcomes)
Alcohol and tobacco have what kind of affect in regards to risk of oral cancer
synergistic effect
What two viruses contribute to oral cancers
HPV and EBV
What often precedes oral cavity squamous cell carcinoma
- leukoplakia
- erythroplakia
- speckled erythroplakia
What often precedes head and neck cancers?
NOTHING
Leukoplakia classification
- hyperplasia
- dysplasia
- carcinoma in situ
- carcinoma
Erythroplakia
- fiery red patch that cannot be clinically identified as anything else
- shows evidence of high grade dysplasia, carcinoma in situ or invasive SCC
Where do the majority of tongue lesions appear
lateral and ventrolateral aspects
Most common chief complaint for oropharyngeal squamous cell carcinoma
- presence of a neck mass
- sore throat
- dysphagia
What often precedes invasive oral SCC
malignant changes of oral mucosa
Symptoms of head/neck cancer
- pain
- otalgia
- dysphagia
- odynophagia
- airway obstruction
Signs of head/neck cancer
- cervical lymphadenopathy
- cranial neuropathies
- decreased tongue mobility
- fistuals
- skin involvement
Most common site of laryngeal cancer
glottis (true vocal cords)
Cancer where spreads to the lymph nodes early
supraglottis (epiglottis, false vocal cords)
Granular leukoplakia
small leukoplakic lesion with rough, granular surface on the posterior lateral border of the tongue
What does biopsy reveal in granular leukoplakia
early invasive squamous cell carcinoma
Size of stage I OC-SSCs
less than 2 cm
Size of stage II cancers
2-4 cm
Imaging for head and neck lesions
- contrast/noncontrast CT of head and neck
- additional scans to asses lesions and stage cancer
Major determinant of survival from head and neck lesions
HPV status of the tumor
