HEAD & NECK CANCER Flashcards

1
Q

What does head and neck cancer include?

A

Oral cavity cancers
Cancers of the pharynx (including the oropharynx, hypopharynx and nasopharynx)
Cancers of the larynx

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2
Q

NICE suspected cancer pathway referral criteria for ?laryngeal cancer?

A

people aged 45 years and over with:
Persistent unexplained hoarseness, or
An unexplained lump in the neck.

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3
Q

NICE suspected cancer pathway referral criteria for ?oral cancer?

A

people with either:
Unexplained ulceration in the oral cavity lasting for more than 3 weeks, or
A persistent and unexplained lump in the neck .

for assessment for possible oral cancer by a dentist in people who have either:
A lump on the lip or in the oral cavity, or
A red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia.

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4
Q

NICE suspected cancer pathway referral criteria for ?thyroid cancer?

A

people with an unexplained thyroid lump.

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5
Q

What is the field of cancerisation effect?

A

a biological process in which large areas of cells at a tissue surface or within an organ are affected by carcinogenic alterations.

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6
Q

Why % of pt with head and neck cancers have a second primary malignancy? Why?

A

1 in 10
Due to the field of cancerisation effect

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7
Q

Whats the most common site for head & neck malignancy?

A

Oral

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8
Q

Most common type of head and neck cancer?

A

Squamous cell carcinoma

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9
Q

Presentation of laryngeal cancer?

A

Hoarseness
Throat pain
Dysphagia

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10
Q

Method of diagnosis for laryngeal cancer?

A

laryngoscopy and biopsy

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11
Q

How does oral cancer present?

A

persistent ulceration, a mass, or abnormal bleeding.
It can present as advanced disease with regional lymphadenopathy.

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12
Q

How do we diagnose oral cancer?

A

Some recognised visually but definitive diagnosis requires a biopsy

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13
Q

How does thyroid cancer present?

A

Nodule within the thyroid gland or a diffuse thyroid swelling
May also present with regional lymphadenopathy

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14
Q

Whats the most common type of thyroid cancer?

A

Papillary

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15
Q

Who is papillary thyroid cancer most common in?

A

Young females

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16
Q

How do we diagnose thyroid cancer?

A

Definitively by biopsy

17
Q

Risk factors for head and neck cancers?

A

Smoking
Chewing tobacco
Chewing betel nut
Alcohol
HPV
EBV

18
Q

Which thyroid cancer has the best prognosis?

A

Papillary thyroid cancer

19
Q

Whats the most common salivary gland for a tumour?

A

Parotid gland

20
Q

What are the most common benign tumours of salivary glands?

A

Pleomorphic adenomas

21
Q

Symptoms of maligannt salivary gland tumours?

A

Rapidly growing painful mass with overlying skin ulceration
Facial palsy

22
Q

How does a benign pleomorphic adenoma present?

A

Painless, slowly enlarging lump in the retromandibular region

23
Q

Why must benign pleomorphic adenomas be surgically removed?

A

As they have a 10% malignant transformation potential

24
Q

Whats the most common salivary gland cancer?

A

Mucoepidermoid tumour - most commonly in parotid gland

25
Q

Big risk factor for carcinoma of the lip?

A

Sun exposure

26
Q

Where is carcinoma of the nasopharynx high in incidence?

A

North and South Asia. - rare here

27
Q

Biggest risk factor for carcinoma of the nasopharynx?

A

EBV

28
Q

Presentation of carcinoma of the nasopharynx?

A

Cervical lymphadenopathy
Ear pain, secretory otitis media, hearing loss, CN palsies
Epistaxis, discharge from nose, changes in smell, nasal obstruction

29
Q

What are carcinomas of the oropharynx most associated with?

A

Smoking
Alcohol
HPV 16 and 18

30
Q

Which region of the larynx is most common for carcinoma of the larynx?

A

Glottis region

31
Q

Premalignant lesions of oral cancers?

A

Leukoplakia
Erythroplakia

32
Q

What is leukoplakia?

A

A pre malignant condition which presents as white, hard spots on the mucous membranes of the mouth

33
Q

Who is leukoplakia common in?

A

Smokers

34
Q

How do we diagnose leukoplakia?

A

It’s a diagnosis of exclusion
Biopsy

35
Q

Differential diagnosis of leukoplakia?

A

Candidiasis - esp if can be rubbed off
Lichen planus - esp if can be rubbed off
Squamous cell carcinoma

36
Q

What is the rate of malignant transformation of leukoplakia to SCC?

A

1%

37
Q

What is erythroplakia?

A

A red lesion in the mucous membranes
A pre-malignant lesion of SCC

38
Q

What can Fanconi anaemia be a pre malignant condition of?

A

Oral SCC

39
Q

What can Plummer-Vinson syndrome be a pre malignant condition of?

A

Cricopharyngeal carcinoma