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ENT > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What is the incidence of squamous cell carcinoma?

A

90%

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2
Q

What are the aetiological factors leading to head and neck cancers?

A
  • tobacco
  • drugs
  • alcohol
  • HPV and Epstein barr virus
  • nickel and chromium, hardwood dust(occupational exposure)
  • chronic dental caries
  • genetic factors such as MEN-multiple endocrine neoplasia
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3
Q

What is dysplasia and what is the classification?

A

The pathological term to describe a change in the cell epithelium
-mild, moderate, severe and carcinoma in situ

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4
Q

What are some pre-malignant manifestations of neoplasia?

A
  • leukoplakia(white patch)

- erythroplasia(red patch)

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5
Q

Which 2 structures get affected by radiotherapy?

A

The spinal cord and the lens of the eye

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6
Q

In regards to surgery for resection how much do you excise around the margin?

A

2 cm

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7
Q

What is the 80/20 rule that relates to malignant and benign causes of neck masses?

A

In adults: 80% are malignant and 20% are benign

In children: 80% neck masses are benign and 20% are malignant

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8
Q

What are the sites infraclavically that lead to neck lumps?

A 
Lungs
Breast
Stomach
Pancreas
Kidney
Prostate
Uterus
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9
Q

What do we find on clinical presentation of a patient with a malignant neck mass?

A
  • dysphasia
  • tender LN
  • dysphonia
  • weight loss
  • referrred otalgia (poor prognostic sign)
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10
Q

Why should we not do an incisional biopsy on a neck mass?

A

It can lead to the risk of implantation

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11
Q

What tissues in the upper aerodigestive tract can produce neoplasia?

A
  • salivary glands
  • lymphoid
  • muscle
  • cartilage
  • thyroid
  • vascular
  • bone
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12
Q

Why is squamous cell the predominantcancer in adults?

A

Because of exposure to carcinogens like:

  • smoking
  • alcohol
  • viruses
  • sepsis
  • foods
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13
Q

Name 6 sinister symptoms that present in a patient with UADT carcinoma?

A
  1. Dysphonia/hoarseness for more than 3 weeks
  2. stridor
  3. dysphagia/odynophagia
  4. weight loss
  5. non healing ulceration
  6. referred otalgia(CN 9 and 10)
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14
Q

What causes recurrent laryngeal nerve palsy?

A
  1. trauma from surgeons
  2. idiopathic
  3. cancers- thyroid, local laryngeal, oesophagus, lung
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15
Q

In children, majority of the neck masses that are benign occur where?

A

Anterior to the sternomastoid muscle in the anterior triangle of the neck. If it is posterior it has a high likelihood of it being malignant

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16
Q

Where is a thyroglossal cyst located in a child?

A

below the hyoid bone and is usually resected to prevent recurrence
Thyroglossal cysts move with swallowing and tongue protrusion

17
Q

What is a dermoid cyst?

A

A congenital cyst found in the submental midline area of a child. It can contain hair, teeth and squamous

18
Q

What are the congenital causes of neck masses in children?

A
  1. Thyroglossal cyst
  2. dermoid cyst
  3. cystic hygroma-transilluminate brilliantly
  4. branchial arch cyst
19
Q

What are the infective causes of neck masses in children?

A
  1. mumps
  2. TB
  3. tonsillitis/quinsy
  4. retropharyngeal abscesses-that leads to acute suppurative otitis media
20
Q

What will you feel on on palpation of lymph nodes in the neck if they are malignant?

A
  1. hard on palpation
  2. immobile (stuck on adjacent structures)
  3. painless
  4. slow growing mass usually in 2 and 3 neck levels
21
Q

What are the 6 neck levels?

A 
I- submental/submandibular
II- upper jugular
III-middle jugular
IV-lower jugular
V-posterior triangle
VI-anterior compartment
22
Q

What other tumours in the neck occur other than squamous cell carcinoma?

A
  1. adenoma
  2. lymphoma
  3. melanoma
  4. thyroid ca
  5. salivary gland tumour
  6. carotid body tumour
23
Q

Hodgkins Lymphoma:

A
  • Common in children and young adults
  • usually a lateral neck mass
  • presents with fever and hepatosplenomegaly
24
Q

Carotid body tumours are more common in?

A

Adults

ENT (8 decks)

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