Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Clinical Medicine > Neoplasms of Head & Neck - Lecture 7 > Flashcards

Neoplasms of Head & Neck - Lecture 7 Flashcards

1
Q

where do neoplasms of head and neck arise from?

A
  • epithelial carcinomas

- arise from mucosal surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what type of carcinoma are most epithelial carcinomas of head and neck?

A

squamous cell carcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

where can lesions occur?

A

nasopharynx, oral cavity, oropharynx, larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

tumors and precancerous lesions?

A
  • SCC
  • leukoplakia
  • melanoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

SCC is most commonly malignancy where?

A

head and neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what can increase risk of oropharyngeal cancer?

A

Smoking, ETOH abuse, and/or being infected with HPV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are oral cavity cancers associated with?

A
  • Non-healing ulcers or masses

- Dental changes or poorly fitting dentures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

are oral cavity cancers anterior or posterior cancers?

A

anterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

how do tongue and lip cancers present as?

A

exophytic or ulcerative leasions often associated with pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is most affected with cancer, tongue or lip?

A

tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is major risk factor for tongue and lip cancers?

A

tobacco/ETOH

-also synergistic effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

where do posterior cancers occur?

A

oropharynx

  • SCC most common
  • HPV major risk factor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

do malignant oral lesions have big or little improvement in early detection?

A

-Little improvement in early detection as many patients do not present until late (Stage III or IV)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

who do most tobacco-related malignant oral lesions occur in?

A

Pts older than 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

who is affected more by malignant oral lesions, male or female?

A

males

-including HPV positive tumors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

malignant oral lesions clinical presentation

A
  • SCC preceded by premalignant changes of oral mucosa (leukoplakia or erythroplakia)
  • as cancer develops, notice presence of non-healing ulcer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

symptoms of later stage of malignant oral lesions?

A
  • bleeding
  • Loosening of teeth
  • Difficulty wearing dentures
  • Dysphagia
  • Dysarthria
  • Hoarseness
  • Development of neck mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

who do you maintain a high index of suspicion for malignant oral lesions?

A

tobacco and alcohol users

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

where do HPV-related malignant head and neck SCC’s arise from?

A

oropharynx, particularly palatine and lingual tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does HPV-16 affect?

A

posterior part of the tongue

  • does NOT produce visible lesions/discolorations
  • NO early warning signs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

who have oral tongue cancers increased in?

A

young women - often with NO significant tobacco or alcohol exposure
(22-44 y.o)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what do head and neck lesions NOT present with?

A

Most head and neck lesions do NOT present with history of premalignant lesions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

symptoms of malignant head and neck lesions?

A
  • Pain – minimal
  • Otalgia
  • Dysphagia
  • Odynophagia
  • Airway obstruction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

signs of malignant head and neck lesions?

A
  • Cervical lymphadenopathy
  • Cranial neuropathies
  • Decreased tongue mobility
  • Fistulas
  • Skin involvement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

locations of malignant head and neck lesions in pharynx?

A

nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

locations of malignant head and neck lesions in oropharynx?

A
  • Tongue base
  • Soft palate
  • Palatine tonsils
  • Posterior wall of pharynx
27
Q

locations of malignant head and neck lesions in hypopharynx?

A

Piriform sinuses and post-cricoid area leading to esophagus below

28
Q

locations of malignant head and neck lesions in glottis?

A
  • True vocal cords
  • Most common site of laryngeal cancer
  • Present with hoarseness
29
Q

locations of malignant head and neck lesions in larynx?

A

Supraglottis

  • Epiglottis and false vocal cords
  • Cancers here spread early to lymph nodes
30
Q

3 categories of oral cavity cancers

A

-Well differentiated
-Moderately well differentiated
-Poorly differentiated
(worse prognosis than well-differentiated)

31
Q

Oral cavity SCC locations

A
  • Lips
  • Tongue
  • Floor of mouth
  • Maxillary alveolar ridge/hard palate
  • Mandibular alveolar ridge
  • Buccal vesitbules
32
Q

what is Oral cavity SCC preceded by?

A

Leukoplakia, erythroplakia, and speckled erythroplakia

33
Q

will most leukoplakia progress to oral cavity SCC?

A

NO, most will not

34
Q

erythroplakia

A

Red, velvety patch similar to white patch

  • Fiery red patch
  • Often well demarcated
  • Cannot be identified clinically or pathologically as any other definable disease
  • Will show evidence of high-grade dysplasia, carcinoma in situ, or invasive SCC
35
Q

speckled erythroplakia

A
  • Combination of red and white features

- May have rough, granular surface

36
Q

what can OC-SCC appear as?

A

ulcer without adjacent mucosal change

37
Q

what will continued growth of OC-SCC result in?

A

a mass with raised, rolled border

38
Q

when does pain/tenderness develop in OC-SCC?

A

develop later in disease

-many other lesions are PAINLESS

39
Q

what is the most common site of OCC-SC in western world?

A

tongue

2nd most common oral site is floor of mouth

40
Q

SCC of tongue lesions appear where?

A

-lateral aspect and ventrolateral aspect of tongue

41
Q

where does oropharyngeal SCC develop?

A

tonsillar region and base of tongue

42
Q

what is appearance in oropharyngeal SCC?

A

ulcerated mass, fullness, or irregular erythematous mucosal change

43
Q

most common chief complaint of oropharyngeal SCC?

A
  • Presence of a neck mass
  • Sore throat
  • Dysphagia (because of location of the mass)
44
Q

how to do PE for all oral cancers?

A
  • Should include inspection of all visible mucosal surfaces

- Palpation of the floor of the mouth, tongue, and neck

45
Q

when do patients usually present in oral cancers?

A

when have enlarged cervical lymph node

-don’t present until stage III or IV

46
Q

stage 1 OC-SCC, how big and do not involve what?

A

<2 cm

-do not involve deep (extrinsic) tongue muscles or mandible

47
Q

T2 cancers, size and involve?

A
  • 2-4 cm
  • May involve adjacent structures
  • May have higher incidence of occult lymph node metastasis
48
Q

if pts have lymph node involvement and no visible primary, what do you do to dx?

A

lymph node excision

49
Q

what imaging is most commonly used for head and neck cancers?

A
  • CT scan

- look for bone involvement

50
Q

what imaging for complete assessment and staging of head and neck cancers?

A

MRI and/or CT/PET

-MRI to look for lymph node or soft tissue involvement

51
Q

what do you do for patients at risk for distant metastasis of head and neck cancers?

A
  • Plain radiography
  • And/or CT of chest
  • And/or CT/PET full body
52
Q

where is metastasis common in pts with advanced neck lymph node disease?

A

lungs, bones, liver

53
Q

pt categories for head and neck cancers

A
  • localized disease
  • advanced disease (local or regionally)
  • recurrent and/or metastatic disease
54
Q

people with advanced disease of head and neck cancers will have what?

A

lymph node positive

55
Q

localized diseased patients graded how?

A

1/3 of pts

-have T1 or T2 lesions without detectable lymph node involvement or distant metastases

56
Q

localized diseased patients treatment?

A

treated with curative intent

  • surgery (for small lesions)
  • radiation therapy (for laryngeal cancer to preserve voice fxn)
57
Q

when do recurrences occur for localized disease?

A

within first 2 years following dx (usually local)

58
Q

advanced disease - how many patients?

A

50% of patients

59
Q

how are advanced disease pts treated?

A
  • w/curative intent

- combine modality therapy (surgery, radiation, chemo)

60
Q

when do you do chemo in advanced disease?

A

before surgery or radiation

61
Q

concomitant treatment for advanced disease

A
  • Simultaneous chemo and radiation

- Most commonly used and supported by best evidence

62
Q

where do pts with advanced disease experience recurrence?

A

outside the head and neck region

63
Q

for recurrent or metastatic disease, how are they treated?

A

palliative intent

  • radiation (for pain control)
  • chemo

Clinical Medicine (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions