Head Neck Cancer Flashcards
What is an alarming symptom for nasopharyngeal cancer in adults?
Unilateral secretory otitis media
Describe the Sx, Types, Dx, Tx of Nasopharyngeal cancer
SYMPTOMS
* Nasal obstruction, bleeding, discharge
* Hearing problems if eustachian tube obstructed,
otitis media
* Headaches
* Cranial nerve palsy with involvement of the base of
skull
* Neck mass , particularly at the mastoid tip (most
common complaint and first sign)
TYPES
* type 1: squamous cell carcinoma, typically found in the older adult population(HPV)
Unilateral secretory otitis media in an adult patient is an alarming symptom for nasopharyngeal cancer
* type 2: non-keratinizing carcinoma- EBV related
* type 3: undifferentiated carcinoma- EBV related
2,3 mortalite daha düşük ama rekürrens daha yüksek
Dx
* MRI prior imaging
* Biopsy, Gold standard
Tx
* Radiochemotherapy is the primary modality of
treatment for nasopharyngeal cancer
Sx, Risks, Tx of Laryngeal Ca
Laringeal ca:
Bulgular: ses kısıklığı, boğaz ağrısı, öksürük, aspirasyon, disfaji, referred kulak ağrısı, boyunda şişlik, hemoptizi. Patolojide keratin incisi(scc) patognomik.
Risk: yaşlı erkek, alkol, sigara, hpv 16, reflü, mesleki maruziyet(nikel,kadmiyum,ağaç işçiliği), boyuna radyasyon öyküsü
Yerleşim yeri olarak: supraglottik, glottik(erken dönem bulgu verir, en iyi prognoz), subglottik(en kötü prognoz)
Tedavi: cerrahi, rt, kt
T1-T2: rt veya cerrahi(subtotal yeterli)
T3-T4: total laringectomy+adjuvan rt
Supraglottik ve subglottikte profilaktik lenfatik drenaj gerekli
Total laringectomy endikasyonları: T3+, yumuşak doku invazyonu, kıkırdak invazyonu, dil kökü invazyonu
T1: The tumor is only in the subglottis.
T2: The tumor has spread to the vocal cords. Movement of the vocal cords may be affected.
T3: The tumor is limited to the larynx and affects the vocal folds.
T4: The tumor has spread beyond the larynx.
T4a: The tumor has spread to the thyroid cartilage and/or the tissue beyond the larynx.
T4b: The tumor has spread to the area in front of the spine (prevertebral space) or the chest area, or it encases the arteries.
