Neoplasia Flashcards
What is the incidence of squamous cell carcinoma?
90%
What are the aetiological factors leading to head and neck cancers?
- 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
What is dysplasia and what is the classification?
The pathological term to describe a change in the cell epithelium
-mild, moderate, severe and carcinoma in situ
What are some pre-malignant manifestations of neoplasia?
- leukoplakia(white patch)
- erythroplasia(red patch)
Which 2 structures get affected by radiotherapy?
The spinal cord and the lens of the eye
In regards to surgery for resection how much do you excise around the margin?
2 cm
What is the 80/20 rule that relates to malignant and benign causes of neck masses?
In adults: 80% are malignant and 20% are benign
In children: 80% neck masses are benign and 20% are malignant
What are the sites infraclavically that lead to neck lumps?
Lungs Breast Stomach Pancreas Kidney Prostate Uterus
What do we find on clinical presentation of a patient with a malignant neck mass?
- dysphasia
- tender LN
- dysphonia
- weight loss
- referrred otalgia (poor prognostic sign)
Why should we not do an incisional biopsy on a neck mass?
It can lead to the risk of implantation
What tissues in the upper aerodigestive tract can produce neoplasia?
- salivary glands
- lymphoid
- muscle
- cartilage
- thyroid
- vascular
- bone
Why is squamous cell the predominantcancer in adults?
Because of exposure to carcinogens like:
- smoking
- alcohol
- viruses
- sepsis
- foods
Name 6 sinister symptoms that present in a patient with UADT carcinoma?
- Dysphonia/hoarseness for more than 3 weeks
- stridor
- dysphagia/odynophagia
- weight loss
- non healing ulceration
- referred otalgia(CN 9 and 10)
What causes recurrent laryngeal nerve palsy?
- trauma from surgeons
- idiopathic
- cancers- thyroid, local laryngeal, oesophagus, lung
In children, majority of the neck masses that are benign occur where?
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
Where is a thyroglossal cyst located in a child?
below the hyoid bone and is usually resected to prevent recurrence
Thyroglossal cysts move with swallowing and tongue protrusion
What is a dermoid cyst?
A congenital cyst found in the submental midline area of a child. It can contain hair, teeth and squamous
What are the congenital causes of neck masses in children?
- Thyroglossal cyst
- dermoid cyst
- cystic hygroma-transilluminate brilliantly
- branchial arch cyst
What are the infective causes of neck masses in children?
- mumps
- TB
- tonsillitis/quinsy
- retropharyngeal abscesses-that leads to acute suppurative otitis media
What will you feel on on palpation of lymph nodes in the neck if they are malignant?
- hard on palpation
- immobile (stuck on adjacent structures)
- painless
- slow growing mass usually in 2 and 3 neck levels
What are the 6 neck levels?
I- submental/submandibular II- upper jugular III-middle jugular IV-lower jugular V-posterior triangle VI-anterior compartment
What other tumours in the neck occur other than squamous cell carcinoma?
- adenoma
- lymphoma
- melanoma
- thyroid ca
- salivary gland tumour
- carotid body tumour
Hodgkins Lymphoma:
- Common in children and young adults
- usually a lateral neck mass
- presents with fever and hepatosplenomegaly
Carotid body tumours are more common in?
Adults
