Nasopharyngeal Cancer Flashcards

1
Q

What is the m/c initial symptom of NP CA?

A

Neck mass (often painless)

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2
Q

What is the 2nd m/c presenting symptom of NP CA?

A

Serous otitis media from ET obstruction

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3
Q

What is the m/c CN palsy a/w NP CA?

A

CN 6 palsy

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4
Q

What is the infectious disease a/w NP CA?

A

EBV

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5
Q

EBV serology tests

A
  • EA (Early Intracellular Antigen): early antigen
  • VCA (Viral Capsule Antigen): late antigen, most specific immunologic finding in NP CA
  • Low titers of IgA EA and IgA VCA is a poor prognostic sign
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6
Q

Anatomical boundaries of the nasopharynx

A
  • Ant: Choanae
  • Sup: base of the skull (body of the sphenoid)
  • Inf: plane of the soft palate
  • Lat: ET orifices
  • Post: Superior constrictor muscles
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7
Q

What is the m/c site of tumor in the nasopharynx?

A

Fossa of Rosenmuller

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8
Q

What is Passavant’s Ridge

A

Interdigitating superior constrictor muscles that form a band at the posterior pharyngeal wall during swallowing that abuts the soft palate

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9
Q

What are the subsites of NP CA

A
  • Posterior NP wall
  • Lateral NP wall
  • Soft palate
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10
Q

T1 NP CA

A

Confined to NP or extends to OP or nasal cavity (w/o parapharyngeal extension)

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11
Q

T2 NP CA

A

Parapharyngeal extension

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12
Q

T3 NP CA

A

Invades bony structures of the skull base or paranasal sinuses

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13
Q

T4 NP CA

A

Invades intracranially or cranial nerves, hypopharynx, orbit, or extends to infratemporal fossa/masticator space

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14
Q

WHO Classification

A

World Health Organization classification based on histopathology

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15
Q

WHO Type I

A

Keratinizing SCCa

  • 2nd m/c subtype
  • Squamous differentiation
  • Not a/w EBV
  • Worse prognosis
  • Less sensitive to RT
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16
Q

WHO Type II

A

Nonkeratinizing SCCa

  • No squamous differentiation
  • A/w EBV
  • Better prognosis
  • Sensitive to RT
17
Q

WHO Type III

A

Undifferentiated

  • Includes lymphoepithelioma, anaplastic, and clear cell variants
  • M/c subtype
  • Indistinct cell margins
  • May have lymphocytic stroma (lymphoepithelioma)
  • A/w EBV
  • Better prognosis
  • Sensitive to RT
18
Q

MAN of Stage I and II NP CA

A

RT to primary site and b/l necks

19
Q

MAN of Stage III and IV NP CA

A

Chemo/RT then adjuvant chemo