HEAD & NECK TUMOURS Flashcards
Region described from the ___________ to the _________________.
- excludes tumours of the ___________ contents and tumours of the ___________ and ___________
cranium ; base of the neck.
intracranial
globe and orbit
Head and neck tumors
Constitutes ____% of all cancers
Approx 500,000 cases diagnosed annually Approx. 300,000 deaths worldwide
Male : Female ___:____
3-5
2:1
Head and neck tumors Can be
- __________ , __________ or __________
- __________ and __________ tumours.
Can be
- benign, intermediate or malignant
- Epithelial and non-epithelial tumours.
Generally –
Benign:
*___________
* ___________
* ___________
* ___________
*Fibroma/angiofibromas
*mixed
*Papillomas
*Adenomas
*Chondromas
*Neuromas
*Fibroma/angiofibromas
*mixed
Generally:-
Malignant:
* ____________ carcinoma
* ____________
* ________carcinoma/Adenocystic Ca.
* ____________/____________/____________ Ca.
*Melanomas
* ________Cell Carcinoma
*Neuroblastoma
Malignant:
* Squamous cell carcinoma
*Lymphoma
*Adenocarcinoma/Adenocystic Ca. *Papillary/Medullary/Follicular Ca.
*Melanomas
*Basal Cell Carcinoma
*Neuroblastoma
Generally:-
Intermediate: *_____________
*Ameloblastoma
* Chemodectomas
Inverted papilloma
Manifestations of head and neck tumors
- Dependent on _____________
- _____________ enlargement
- _________ in affected areas
- Signs of _____________
Manifestations
- Dependent on the site affected
- Lymph node enlargement
- Pain in affected areas
- Signs of metastasis
Larynx
‘Voice box’
Males: female ratio : ____:___
Risk Factors –________,_______ , __________ lesion- laryngeal papilloma, previous ________, long standing __________
1-7:1
smoking , alcohol
pre- cancerous
irradiation; reflux laryngitis
Diagnosis of laryngeal tumors= hx, exam + inv
Hoarseness- _________ and ___________
Noisy/difficulty in breathing/________ . Airway obstruction
Aspiration
Video Laryngoscopy - Vocal/supraglottic lesion
CT/MRI – extent of tumour + nodal met. Biopsy carried out commonly under G.A
progressive and unremitting
stridor
Classification of laryngeal tumor - T N M
T1 – tumour is _____________, may involve ant. or post. Commissure with ___________
T2- Tumour extends to_______________ with impaired ___________
T3-Tumor limited to the _________ with __________
T4a- Tumor ________ the larynx.
T4b- encases _________, invades ____________
limited to the VC; normal mobility
supraglottic or subglottic; VC mobility
larynx with VC fixation
beyond
carotid; mediastinum
Nodal classification
N1- ____lateral node <___cm
N2a- ____lateral node >___ but </=___cm
N2b-multiple _____lat. Nodes ______ >6cm
N2c- ______lateral node/——lateral nodes none >6cm
N3- Any node>6cm
ipsi;3
ipsi;3;6
ipsi; none
contra;bi
Treatment of laryngeal tumor
Initial __________ for pt with airway obstruction.
Surgery – __________-total or partial, Partial- Vertical or Horizontal
Total- complete removal with a ____________________ , +/-speaking valve/voice prosthesis.
+/-Neck Dissection where there is nodal metastasis.
•___________
tracheostomy
Laryngectomy
permanent tracheostomy
Radiation
Prognosis in laryngeal tumors
In early stages nearly _____% 5year survival rate
Late stages _______% 5 year survival.
100
30-45
Nasopharyngeal tumour
Occur within the nasopharyngeal space Often from the __________________
Closely related to the ____________ and ____________ space
Anteriorly with the ____________
Superiorly -____________ (basi-sphenoid) Supero-laterally -____________
Inferiorly the -____________
fossa of Rossenmuller
eustachian tube ; parapharyngeal space
nasal cavity ; base of skull
orbit ; oropharynx
Nasopharyngeal tumors
epidemiology
Occurs 1/100,000 per population
Most prevalent among the _________ and and people of _________ descent,
Higher among the _________ within the subregion
Higher among _________/_________ americans
Chinese ; asian
North africans
chinese/asian americans
Risk Factors of nasopharyngeal tumors
_____ gender
Ingestion of ____________ meals and other nitrosamine containing diets
____________ of NPC
____________ infection
Genetic factors
Tobacco, Alcohol
Exposure to ____________
Male ; salted ungutted meals
Family hx ; Ebstein Barr Virus
wood dust
Diagnosis of nasopharyngeal tumors- hx, exam
Nasal obstruction
__________
____________ hearing loss
Cervical lymphadenopathy
_________/_________/________
Nasoendoscopy &
Biopsy of nasopharyngeal mass for Histopathology
Epistaxis; Conductive
Proptosis; diolopia; headache
Oropharyngeal tumor
Area bounded by
1. ________________ and the ____________
2. The ________ /________ fossae
3. Oropharyngeal surface of the soft palate and the oropharyngeal isthmus
4. Communicates inferiorly with the ________ and ________
Anterior faucial pillars ; base of the tongue
tonsil/tonsillar
larynx and hypopharynx
Risks of Oropharynheal tumors
__________
Heavy _______ use
________ infection
Previous head and neck tumor
Previous _________ to the head and neck
Risks
Smoking
Heavy alcohol use
HPV 16 infection
Previous head and neck tumor
Previous radiation to the head and neck
Sinonasal tumours
Tumours of the nose and paranasal sinuses
Constitutes <1% of all tumours
Late presentation/diagnosis due to non- specificity of early symptoms often taken for usual ‘_______’
catarrh
