head and neckc squamous cancers Flashcards
symptoms
neck pain/lump, sore throat >6 weeks, hoarse voice >6 weeks, mouth bleeding, mouth numbness, sore tongue, lumps in the mouth, dysphagia, epistaxis, painless ulcers, earache/effusion, speech change
associations nasopharyngeal cancer
HLA A2, HPV, EBV, tobacco, formaldehyde
T staging nasopharyngeal
1- naso, oro pharynx or nasal cavity; 2- parapharyngeal extension; 3- bony structure; 4- intracranial, CN
N staging nasopharyngeal
1- unilat cervical, retropharyngeal; 2- bilat cervical abover supraclav fossa; 3 >6 cm
what is stage 2 nasopharyngeal
T1N1 to T2NO-1
what is stage 3 nasopharyngeal
T1,2N2 to T3N0-2
diagnosis nasopharyngeal
endoscopy/biopsy, PCR for EBV
treatment nasopharyngeal cancer
radiotherapy +- chemo +- surgery
what is the 3 year survival for nasopharyngeal stage 2
100%
how does oropharyngeal present
often advanced at presentation. males to females 5:1. typical older patient- smoker with sore throat, sensation of throat, otalgia, local irritation with hot and cold foods
treatment in oropharyngeal
surgery- jejunal flaps, tubed skin flaps. radiotherapy
presentation hypopharyngeal
rare, in elderly. lump in throat, dysphagia, neck lumps
what is the typical patient in squamous cell laryngeal cancer
older patient- smoker with progressive hoarseness, stridor, dysphagia or odynophagia, haemoptysis, ear pain
what is the association with squamous cell laryngeal cancer in younger patients
HPV
diagnosis squamous cell laryngeal cancer
laryngoscopy, biopsy
treatment squamous cell laryngeal cancer
radiotherapy, laryngectomy
what happens after a total laryngectomy
permanent tracheostomy- need to learn oesophageal speech
when should you suspect sinus squamous cell cancer
middle aged, elderly patient. chronic sinusitis presenting for the first time in later life
signs sinus squamous cell cancer
early- blood stained nasal discharge, nasal obstruction. later- cheek swelling, swelling or ulcers of plate or palate, epiphora, ptosis, diplopia
why do patients present late in sinus squamous cell cancer
because epistaxis, obstruction, headache only occur with large tumours
imaging in sinus squamous cell cancer
MRI/CT +- endoscopy
treatment sinus squamous cell cancer
radiotherapy +- radical surgery
