Neck lumps Flashcards
investigations for lymphadenopathy
Ultrasound scan
FNA cytology
CT scan
5 risk factors for squamous cell carcinoma
- Human papilloma virus
- Epstein Barr virus
- Betel nut chewing
- Alcohol
- Smoking
Human papilloma virus increases risk of;
head and neck cancers in younger patients (20-40s)
Epstein Barr virus increases risk of;
nasopharyngeal carcinoma
Betel nut chewing increases risk of;
oropharyngeal carcinoma
alcohol increases the risk of;
upper aerodigestive tract malignancy
management of Squamous cell carcinoma
- Panendoscopy + biopsy
- CT skull base to diaphragm
- MDT discussion
causes of lympahdenopathy? (2)
- infection
- metastatic spread from a carincoma
Dysphonia is…
hoarse voice
pathology of the larynx that can cause Dysphonia (3)
- Acute laryngitis
- Chronic laryngitis
- SCC of larynx
how can thyroid disease cause dysphonia?
malignant thyroid disease invading the recurrent laryngeal nerve
differentials for a vocal cord lesion (2)
- SCC of larynx
- Vocal fold polyp
findings on examination of larynx with a flexible nasendoscope?
- white coloured lesion; if the SCC produces keratin
what are vocal fold polyps?
inflammatory lesions of the vocal fold usually resulting from overuse
management of vocal fold polyp?
- speech therapy
- surgery using endoscope, microscope and specialised laryngeal surgery may be required
investigations of vocal fold lesion
- FNA cytology
- Ultrasound of neck
- CT scan neck + chest
management of metastatic SCC
- radiotherapy
- surgical
- chemotherapy
- palliative management for symptom control
- rehabilitation (voice + swallowing problems)
TNM staging is …
Tumour size
Nodes involved
Mets presence
most common thyroid cancer is ? and 2nd most common
1st = Papillary 2nd = Follicular
causes of generalised thyroid swellings (3)
- Multinodular goitre
- Hashimotos
- Graves disease
what is stridor
inspiratory noisy breathing suggesting narrowing of the upper airway
cause of unexplained hoarseness
invasion of recurrent laryngeal nerve or the larynx
Management of Papillary + Follicular Thyroid carcinomas (3)
- Total thyroidectomy
- Followed by radioiodine to kill residual cells
- Yearly thyroglobulin levels to detect early recurrent disease
what is Reinke’s oedema
Condition where the vocal folds become v. oedematous w/ accumulation of a gelatinous material within the fold
Management of Reinke’s oedema
- smoking cessation
- GORD control
- incision of the vocal fold with removal of gelatinous material
