Head and neck neoplasms

Question 1

What is the most common malignant head and neck lesion

Answer 1

squamous cell carcinoma

Question 2

Structures of oropharynx

Answer 2

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

Question 3

what are oral cancers associated with

Answer 3

• non healing ulcers or masses

- dental changes of poorly fitting dentures

Question 4

Presentation of tongue and lip cancers

Answer 4

exophytic or ulcerative lesions often associated with pain

Question 5

Most of the pts with primary tongue lesions have disease where

Answer 5

nodal disease

Question 6

Major risk factors for tongue and lip cancer

Answer 6

tobacco/ETOH

Question 7

Risk factor for cancer of oropharynx

Answer 7

HPV

Question 8

Most common malignancy of the head and neck

Answer 8

oral cavity squamous cell carcinoma

Question 9

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

Answer 9

oropharynx, palatine and lingual tonsils

Question 10

What other structure does HPV16 affect

Answer 10

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

Question 11

three categories of oropharynx cancer

Answer 11

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

Question 12

What threee categories is oral cancer divided into

Answer 12

• well differentiated
• moderately well differentiated
• poorly differentiated (poor outcomes)

Question 13

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

Answer 13

synergistic effect

Question 14

What two viruses contribute to oral cancers

Answer 14

HPV and EBV

Question 15

What often precedes oral cavity squamous cell carcinoma

Answer 15

• leukoplakia
• erythroplakia
• speckled erythroplakia

Question 16

What often precedes head and neck cancers?

Answer 16

NOTHING

Question 17

Leukoplakia classification

Answer 17

• hyperplasia
• dysplasia
• carcinoma in situ
• carcinoma

Question 18

Erythroplakia

Answer 18

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

Question 19

Where do the majority of tongue lesions appear

Answer 19

lateral and ventrolateral aspects

Question 20

Most common chief complaint for oropharyngeal squamous cell carcinoma

Answer 20

• presence of a neck mass
• sore throat
• dysphagia

Question 21

What often precedes invasive oral SCC

Answer 21

malignant changes of oral mucosa

Question 22

Symptoms of head/neck cancer

Answer 22

• pain
• otalgia
• dysphagia
• odynophagia
• airway obstruction

Question 23

Signs of head/neck cancer

Answer 23

• cervical lymphadenopathy
• cranial neuropathies
• decreased tongue mobility
• fistuals
• skin involvement

Question 24

Most common site of laryngeal cancer

Answer 24

glottis (true vocal cords)

Question 25

Cancer where spreads to the lymph nodes early

Answer 25

supraglottis (epiglottis, false vocal cords)

Question 26

Granular leukoplakia

Answer 26

small leukoplakic lesion with rough, granular surface on the posterior lateral border of the tongue

Question 27

What does biopsy reveal in granular leukoplakia

Answer 27

early invasive squamous cell carcinoma

Question 28

Size of stage I OC-SSCs

Answer 28

less than 2 cm

Question 29

Size of stage II cancers

Answer 29

2-4 cm

Question 30

Imaging for head and neck lesions

Answer 30

• contrast/noncontrast CT of head and neck

- additional scans to asses lesions and stage cancer

Question 31

Major determinant of survival from head and neck lesions

Answer 31

HPV status of the tumor